腹腔镜胆囊切除术治疗高龄患者急性胆囊炎的临床观察

目的：探讨腹腔镜胆囊切除术治疗高龄患者急性胆囊炎的应用价值。方法：回顾性分析2005年1月．2011年12月我院收治的210例65岁以上因急性胆囊炎实施胆囊切除术的老年患者的临床资料，按手术方式分为腹腔镜组（LC组）和剖腹胆囊切除术组（OC组），分析和比较两组患者的手术时间、术后肠功能恢复时间及住院时间，术中出血、腹腔引流量和术后并发症的发生情况。结果：与OC组比较，LC组的手术时间、术后肠功能恢复时间及住院时间均显著缩短，差异有统计学意义（P〈0．01）；但两组之间术中出血、腹腔引流量和术后并发症的发生率差异均无统计学意义（P〉0．05）。LC组中转开腹10例，占7_35％；其中粘连严重导致胆囊三角解剖不清6例，无法控制的出血2例，结石嵌顿胆囊管2例。结论：老年急性胆囊炎患者在条件合适的情况下行腹腔镜胆囊切除术治疗有助于患者更快地恢复．具有较强的临床应用价值。

Clinical Observation on the Application of Laparoscopic Cholecystectomy in the Treatment of Acute Cholecystitis in Elderly Patients

Objective： To investigate the clinical efficacy and value of laparoscopic surgery for elderly patients with acute cholecystitis. Methods： From January 2005 to December 2011, the clinical data of 210 cases of implementation of acute cholecystitis cholecystectomy in elderly patients（over the age of 65 ）were Retrospectively analyzed, surgical approach is divided into the laparoscopic group （LC group ） and laparotomy cholecystectomy group （OC group）, the operation time, postoperative intestinal function recovery time, hospitalization time, blood loss, abdominal drainage flow and the occurrence of postoperative complications were analyzed and compared. Results： Compared with the OC group, perative time, postoperative intestinal function recovery time and hospital stay of the LC group were significantly shortened, the difference was statistically significant （P 〈 0.01）; blood loss, peritoneal drainage and postoperative the incidence of complications of the two groups was no significant difference （P〉0.05）. 10 cases of The LC group converted to open, accounting for 7.35%; including severe adhesion causes the gallbladder the Triangle anatomy unclear six cases, unable to control bleeding in 2 cases, 2 cases of cystic duct stone impaction. Conclusion： Elderly patients with acute cholecystitis in the suitable conditions laparoscopic cholecystectomy treatment helps patients recover more quickly, and had a strong clinical value.