| 摘要: |
| 目的 探讨老年人腹腔镜胆囊切除术（LC）的临床特点，评估老年人接受LC的安全性。方法 选取我院2020年1月至2022年1月行LC的182患者为研究对象，比较老年组（年龄≥60岁）和非老年组（年龄＜60）患者的病程、基础疾病、手术时间、出血量、并发症、住院时间等临床资料，总结老年人胆囊疾病特点及安全手术经验。结果 老年组患者80例，男34例、女46例；非老年组102例，男53例、女49例。与非老年组相比，老年组的合并的基础疾病多［71.25%（57/80）vs 20.59%（21/102），P＜0.05］，有上腹部手术史的患者多［7.50%（6/80）vs 0（0/102），P＜0.05］，手术时间长［（69.04±31.57）min vs （55.29±21.22）min，P＜0.05］，术中出血量增多［30.00（10.00，30.00）mL vs 20.00（20.00，50.00）mL，P＜0.05］，总住院天数多［（6.10±3.97）d vs （4.89±2.53） d，P＜0.05］。两组的术后并发症和术后住院天数差异无统计学意义（均P＞0.05）。术后病理提示老年组中有2例为胆囊腺瘤样增生伴高级别上皮内瘤变，无胆囊恶性肿瘤。结论 老年患者合并的基础疾病较多，严格把握手术适应证，术中精细操作，术后精心护理，是老年人LC成功的重要因素。 |
| 关键词: 腹腔镜胆囊切除术 老年人 基础疾病 临床经验 |
| DOI：10.16781/j.CN31-2187/R.20220229 |
| 投稿时间：2022-03-18修订日期：2022-12-22 |
| 基金项目: |
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| Clinical analysis of laparoscopic cholecystectomy in the elderly |
| ZHU Zhongfei,HU Hao* |
(Department of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To explore the clinical characteristics of laparoscopic cholecystectomy (LC) in the elderly and evaluate the safety of LC. Methods A total of 182 patients who underwent LC in our hospital from Jan. 2020 to Jan. 2022 were enrolled. The clinical data of the course of disease, underlying diseases, operation time, blood loss, complications, length of hospital stay and other clinical data of the elderly group (age≥60 years) and the non-elderly group (age＜60 years) were compared, and the characteristics of gallbladder diseases and the experience of safe operation in the elderly were summarized. Results There were 80 elderly patients, including 34 males and 46 females; there were 102 non-elderly patients, including 53 males and 49 females. Compared with the non-elderly group, the operation time in the elderly group was significantly longer (［69.04±31.57］ min vs ［55.29±21.22］ min, P＜0.05), with more underlying diseases (71.25%［57/80］ vs 20.59%［21/102］, P＜0.05), more patients with previous upper abdominal surgery［7.50% (6/80) vs 0 (0/102), P＜0.05］, more intraoperative blood loss (30.00［10.00, 30.00］mL vs 20.00［20.00, 50.00］mL, P＜0.05), and greater total length of hospital stay (［6.10±3.97］ d vs ［4.89±2.53］ d, P＜0.05). There was no significant difference in postoperative complications or postoperative hospital stay between the 2 groups (all P＞0.05). Postoperative pathology showed that 2 cases in the elderly group were gallbladder adenomatous hyperplasia with high-grade intraepithelial neoplasia, without gallbladder malignant tumor. Conclusion There are many underlying diseases in elderly patients. Controlling the surgical indications properly, careful operation and nursing are important factors for the success of LC in the elderly. |
| Key words: laparoscopic cholecystectomy aged underlying diseases clinical experience |
