摘要
目的 探讨预防和减少老年患者腹腔镜胆囊切除术（laparoscopic cholecystectomy）并发症的方法。方法 2000年1月～2006年10月,对182例60～85岁患者行LC,有合并症者87例。气管插管静脉复合全身麻醉,三孔法137例,四孔法45例。结果 LC成功174例,手术时间30～100 min,术后住院时间3～10 d。中转开腹8例,原因为手术困难6例,术中证实胆囊癌2例,无死亡和严重并发症发生,戳孔感染3例,肺部感染2例。随访3～12个月,无腹痛、黄疸和发热等并发症。结论 老年患者进行LC是安全可行的,术者应该技术熟练,严格选择手术适应证,相对放宽中转开腹的指征,才能预防和减少并发症。
Objective To investigate the prevention and countermeasures of complications following laparoscopic cholecystectomy （LC） in aged patients. Methods The study was based on a retrospective view of clinical date of 182 aged patients （60 -85 years old） who had been treated with LC from January 2000 to October 2006 in this hospital. Co-morbidities existed in 87 patients. The operation was performed under general anesthesia and endotracheal intubation, by using 3-port technique in 137 patients and g-port technique in 45 patients. Results The LC was successfully completed in 174 patients, with an operation time of 30 100 rain and a postoperative hospital stay of 3- 10 d. Conversions to open surgery were required in 8 patients due to a difficult dissection （6 patients） or a diagnosis of gallbladder carcinoma （2 patients）. No death or serious complications occurred. There were 3 patients with port-site infection and 2 patients with pulmonary infection. Follow-up observations in the patients for 3- 12 months revealed no abdominal pain, fever, or jaundice. Conclusions Strictly following indications, properly treating the accompanying diseases, and promptly converting to open surgery are key factors to prevent and reduce complications of LC in aged patients.
出处
《中国微创外科杂志》
CSCD
2007年第7期674-675,共2页
Chinese Journal of Minimally Invasive Surgery
