摘要
目的探讨日间手术腹腔镜胆囊切除(LC/DS)的可行性和安全性,评价65岁以上老年患者LC/DS手术的效果。方法回顾性分析2009年11月至2010年12月我院1240例LC/DS临床资料,分析其并发症、延迟出院和再入院原因。比较65岁以下和老年患者LC/DS治疗效果。结果 1240例中1236例LC/DS手术成功,中转开腹4例(0.32%)。共发生6例(0.48%)并发症。延迟出院125例(10.1%),其中49例(39.2%)因心理因素延迟出院,34例(27.2%)因手术后呕吐和腹痛延迟出院。再入院15例(1.2%),8例因胆囊癌再入院。老年患者LC/DS无严重并发症,患者满意度与65岁以下组差异无统计学意义(P>0.05),延迟出院和再入院比例高于65岁以下组(P<0.01)。结论日间手术腹腔镜胆囊切除安全可行,经选择的老年患者同样适合LC/DS医疗模式。心理因素、呕吐和腹痛是导致患者延迟出院的主要原因。
Objective To explore the feasibility and safety of day surgery laparoscopic cholecystectomy（LC/DS）,and to evaluate the outcome of LC/DS in aged patients（more than 65 years）.Methods 1240 patients undergoing LC/DS in our hospital between November 2009 and December 2010 were retrospectively studied.The complications and reasons of delayed discharge and readmission were analyzed.The treatment effectiveness of LC/DS in aged patients was compared with that of patients younger than 65 years.Results Among 1240 patients of LC/DS group,1236 cases were preformed by LC and 4 cases were conversd to laparotomy（0.32%）.Complications were developed in six cases（0.48%）.125（10.1%）patients were not discharged within 24 hours of the operation,among whom 49（39.2%）refused discharge for psychological factor,34（27.2%）for postoperative omitting and abdominal pain.15 patients were readmitted,among whom 8 cases were unexpected gallbladder carcinomas.There was no significant complications in aged patients.The satisfaction rate has no difference compared with that of patients younger than 65 years（P0.05）,while rate of delayed discharge and readmission rate in aged patients group was higher than in patients younger than 65 years（P0.01）.Conclusion The day surgery laparoscopic cholecystectomy is feasibile and safe,the day surgery procedure is also suitable for selected aged patients.Psychological factor,postoperative vomitting and abdominal pain are the main causes of delayed discharge.
出处
《临床肝胆病杂志》
CAS
2011年第9期912-915,共4页
Journal of Clinical Hepatology
关键词
胆囊疾病
胆囊切除术
腹腔镜
日间手术
gallbladder diseases
cholecystectomy
laparoscopic
day surgery
