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目的探讨腹腔镜胆囊切除术(LC)治疗老年人急性胆囊炎的可行性及临床疗效。方法回顾2008年1月—2011年2月收治的135例老年人(≥65岁)急性胆囊炎患者均实施腹腔镜胆囊切除术(LC)的临床资料,对其手术时间、中转开腹例数、术后并发症、住院天数等临床资料进行回顾性分析。结果 135例LC中,完成131例,成功率97.04%;中转开腹4例,中转开腹率2.96%。术后并发症5例(3.7%),包括胆瘘1例,皮下气肿1例,肺部感染2例,腹壁戳孔出血1例。无死亡病例,均治愈出院。结论老年急性胆囊炎患者行腹腔镜手术是安全可行的,应该成为首选的治疗方法。应重视围手术期处理,合理选择手术时机、术中细致操作、适时中转开腹可减少和避免术后并发症的发生。
Objective To investigate the feasibility and clinical efficacy of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis in the elderly. Methods The clinical data of laparoscopic cholecystectomy (LC) were retrospectively analyzed in 135 elderly (≥65 years) patients with acute cholecystitis admitted from January 2008 to February 2011. The operative time, number of laparotomy , Postoperative complications, hospitalization days and other clinical data were retrospectively analyzed. Results Of the 135 cases of LC, 131 cases were completed, with a success rate of 97.04%; 4 cases were converted to laparotomy and the rate of laparotomy was 2.96%. Postoperative complications occurred in 5 cases (3.7%), including 1 case of biliary fistula, 1 case of subcutaneous emphysema, 2 cases of pulmonary infection and 1 case of abdominal puncture bleeding. No deaths were cured. Conclusions Laparoscopic surgery in elderly patients with acute cholecystitis is safe and feasible, and should become the first choice of treatment. Should pay attention to perioperative management, a reasonable choice of timing of surgery, intraoperative meticulous operation, timely conversion to open surgery can reduce and avoid the occurrence of postoperative complications.