腹腔镜胆囊切除术:老年患者手术的挑战和结果

Ashwani Kumar, R. Kapoor, Sarbjeet Singh, Amandeep Singh, S. Mahajan
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摘要

引言:与年轻人相比,胆结石病除了有合并症和较差的生理储备外,在老年人群中更为普遍。腹腔镜手术有一定的内在技术限制和独特的生理要求。因此,该手术在老年患者中可能有更高的并发症,需要对该年龄段的患者进行评估。目的:本研究旨在从术前和术中困难、术后并发症、发病率和死亡率等方面评估老年患者腹腔镜胆囊切除术的安全性。材料和方法:本研究进行了回顾性研究,收集了2012年至2017年期间共390名接受手术的患者(45名老年患者)的医院记录数据。结果:老年患者的平均年龄为66.7岁。所有接受腹腔镜胆囊切除术的患者的美国麻醉师协会(ASA)评分均为I或II。35.55%的患者在术中遇到困难。平均住院时间为2.5天。一名患者出现轻微胆汁泄漏。未发生死亡。结论:老年患者腹腔镜胆囊切除术是安全的。
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Laparoscopic Cholecystectomy: Challenges and Outcomes of the Procedure in Elderly Patients
Introduction: Gallstone disease is more prevalent in the elderly population besides having comorbid conditions and poor physiological reserves as compared with their younger counterpart. Laparoscopic procedures have certain inherent technical limitations and unique physiological demands. Hence, the procedures may have higher complications in elderly patients and need evaluation in this age-group of patients. Aim: This study is aimed to evaluate the safety of the procedure of laparoscopic cholecystectomy in elderly patients in terms of preoperative and intraoperative difficulties, postoperative complications, morbidity, and mortality. Materials and methods: The study was conducted retrospectively, collecting data from hospital record of a total of 390 patients (45 elderly patients) operated during a period from 2012 to 2017. Results: The mean age of elderly patients was 66.7 years. All the patients who underwent laparoscopic cholecystectomy had an American Society of Anesthesiologist (ASA) score of I or II. Intraoperative difficulties were encountered in 35.55% patients. Average hospital stay was 2.5 days. One patient had a minor bile leak. No mortality occurred. Conclusion: Procedure of laparoscopic cholecystectomy is safe in elderly patients.
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