高龄患者腹腔镜胆囊切除术的临床分析  

Clinical analysis of laparoscopic cholecystectomy in elderly patients

作　　者：王建国[1] 王崇高[1] 朱乃海[1] 

机构地区：[1]南京市浦口区中心医院普外科,江苏南京211800

出　　处：《临床医药文献电子杂志》2016年第38期7503-7504,共2页Electronic Journal of Clinical Medical Literature

摘　　要：目的探讨腹腔镜胆囊切除术（Laparoscopic cholecystectomy，LC）在治疗80岁以上高龄患者胆囊良性疾病的可行性及临床治疗价值。方法选取我院2010年1月-2015年12月收治的高龄胆囊良性疾病患者34例，在气管插管静脉复合全身麻醉CO2气腹压8-10mmHg条件下，四孔法操作行LC，观察该治疗方法的疗效并加以总结分析。结果31例患者成功实施LC，3例中转开腹，术后7例患者出现并发症，所有患者均痊愈出院。术前平均准备时间为6．16天，平均住院时间为12．4天。结论通过对高龄胆囊良性疾病患者加强围术期处理，积极控制好合并症，术中尽量缩短手术时间，LC对大多数高龄患者而言是安全可行的，值得临床推广。Objective To evaluate the feasibility and clinical value of laparoscopic cholecystectomy in patients over the age of 80. Methods Retrospective analysis of the clinical data was done for the 34 elderly patients over 80-year-old with cholecy stolithiasis who were treated from Jan 2010 to Dec 2015 in our department. The operation was performed under general anesthesia and endotrachal intubation by using 4-port technique, and the CO2 pneumoperitoneum pressure was set at 8 - 10 mmHg, then observe the clinical value of laparoscopic cholecystectomy and made an indeep analysis. Results The laparoscopic cholecystectomy was successfully completed in 31 patiens, while conversion to open surgery was required in 3 patients. The causes of conversion included severe intraperitoneal adhesion in 2 Patients, and suspicion of gallbladder carcinoma in 1 patient. Postoperative complications occurred in 7 patients （10.94%）.All patients were healed,the average of preoperative preparation days were 6.16 and average of days in hospital were 12.4. Conclusion Laparoscopic cholecystectomy is safe, feasible in aged patients.and worth spread. Proper perioperative management, careful prevention co-morbidities, and control of operation time as short as possible are important for senile patients.

关 键 词：胆囊切除术 腹腔镜 高龄患者 

分 类 号：R657.4[医药卫生—外科学]