老年人不同时期行腹腔镜胆囊切除术的临床分析

摘要

目的：探讨老年人不同时期行腹腔镜胆囊切除术(LC)的安全性及临床疗效。方法对本院2009年1月~2013年12月收治的151例行LC治疗老年人的临床资料进行回顾性分析。根据手术时期的差异，将患者分为三组，A组为非急性期手术，B组为胆囊炎急性发作72 h内手术，C组为发病72 h后手术，比较三组的手术时间、术中出血量、术后住院时间、中转开腹率、置管引流率及术后并发症发生率。结果 A组与B组的手术时间、术中出血量、中转开腹率、术后并发症发生率及术后住院时间比较差异无统计学意义(P>0.05)；C组的手术时间、术后住院时间长于A组和B组，术中出血量多于A组和B组，中转开腹率、置管引流率、术后并发症发生率高于A组和B组，差异有统计学意义(P<0.05)。结论老年人行LC选择非急性期和急性发作72 h内手术是安全、可行的。%Objective To discuss the clinical efficacy and safety of laparoscopic cholecystectomy for the elderly in dif-ferent period. Methods The data of 151 cases of elderly patients treated with laparoscopic cholecystectomy were retro-spectively analyzed from January 2009 to December 2013.Patients were divided into there groups according to the dif-ference of operation period.Laparoscopic cholecystectomy in non acute phase was used in group A,laparoscopic chole-cystectomy within 72 hours of acute cholecystitis was used in group B,laparoscopic cholecystectomy after 72 hours of a-cute cholecystitis was used in group C.The operation time,intraoperative blood loss,postoperative hospital stay,open con-version rate,drainage rate and postoperative complication rate of three groups was compared respectively. Results The operation time,intraoperative blood loss,open conversion rate,postoperative complication rate and postoperative hospital stay between group A and group B was compared respectively,with no statistical difference (P>0.05).The operation time and postoperative hospital stay in group C was longer than that in group A and group B respectively,intraoperative blood loss in group C was more than that in group A and group B respectively,open conversion rate,drainage rate and postoperative complication rate in group C was higher than that in group A and group B respectively,with statistical dif-ference (P<0.05). Conclusion Laparoscopic cholecystectomy is a safe and feasible technique in non acute phase and a-cute cholecystitis within 72 hours in the elderly patients.