八旬老人胆囊切除术:近5年经验。

Whanbong Lee
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引用次数: 6

摘要

背景/目的:人口老龄化导致各方面老年患者手术治疗增多。因为胆囊炎而接受手术的患者也越来越多。我们试图重新调查他们明显增加的高龄胆囊炎患者和手术治疗后的结果,以寻求改善治疗效果。方法:2007年3月至2012年2月5年间,共380例高龄患者中57例行胆囊切除术。将患者与老年患者的围手术期随访结果进行比较。结果:老年患者中基础疾病占70%以上。严重的急性胆囊炎更常见于八十多岁的老年人,而内镜逆行胆管造影等手术更常在术前进行,显示更频繁地从腹腔镜手术转换为开放方法。并发症如腹膜炎、败血症、伤口问题,包括死亡率在八十多岁胆囊切除术患者中更为常见。与全胆囊切除术患者组相比,80岁高龄患者各项目出现的问题明显增多(p)结论:胆囊切除术后80岁高龄患者伴随症状和检查时间延长,并发症和死亡率高是不可避免的。手术治疗本身似乎是不可避免的,因此应该让患者了解风险,更加关注护理的各个方面。
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Cholecystectomy in octogenarians: recent 5 years' experience.

Backgrounds/aims: Aging of population is leading to more operative treatments on elderly patients in various aspects. Growing numbers of patients are going through operations about cholecystitis in the same sense. We tried to survey them anew about remarkably increasing octogenarian patients and the outcome after operative management for cholecystitis seeking to improve treatment result.

Methods: For 5 years, from March 2007 to Febraury 2012, 57 octogenarian patients had cholecystectomy among total 380 cases. Patients were compared between total patients and octogenarians on perioperative follow-up findings in medical records.

Results: Underlying diseases were prevailing in octogenarian by more than 70% of cases. Severe acute cholecystitis was more often observed in octogenarians and procedures like endoscopic retrograde cholangiopancreaticography were more often performed preoperatively, showing more frequent conversion to open method from laparoscopic procedure. Complications such as peritonitis, sepsis, wound problem, including mortality were much more common in octogenarian cholecystectomy patients. When compared to total cholecystectomy patient group, octogenarian patients had more problems in every items significantly (p<0.05).

Conclusions: High rates of complications and mortality accompanying prolonged symptoms and examinations was inevitable for octogenarian patients after cholecystectomy. Operative treatment per se appears to be inevitable, thus it should make the patients be informed about risks with more attention to every aspect of care.

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