蔡勇,张建淮,杨晨晨,陈国锋,周传文,许刚

(南京医科大学附属淮安第一医院,1.急诊外科;2.肝胆胰外科;3.消化内科,江苏 淮安　223300)



腹腔镜胆囊切除术治疗老年急性胆囊炎的临床疗效评价

蔡勇1,张建淮2,杨晨晨1,陈国锋2,周传文3,许刚2

(南京医科大学附属淮安第一医院,1.急诊外科;2.肝胆胰外科;3.消化内科,江苏 淮安223300)

目的：探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy，LC)治疗老年急性胆囊炎的临床效果。方法：选取行腹腔镜胆囊切除术的老年急性胆囊炎患者87例为LC组，同期行开腹胆囊切除术(open cholecystectomy，OC)治疗的老年患者70例为OC组，比较两组治疗效果。结果：治疗后，两组总有效率、手术成功率差异无统计学意义(P>0.05)；LC组手术时间、术中出血量、胃肠道恢复时间、住院时间和并发症发生率均低于OC组，差异有统计学意义(P<0.05)。结论：对于老年急性胆囊炎患者，LC组临床疗效优于OC组，具有术后恢复快、并发症少等特点，临床应用价值高。

急性胆囊炎; 胆囊切除术; 腹腔镜; 老年患者

【Abstract】Objective：To investigate the clinical efficacy of laparoscopic cholecystectomy (LC)in the treatment of elderly patients with acute cholecystitis.Methods：Eighty-seven elderly patients with acute cholecystitis who underwent LC were collected as LC group,and 70 elderly patients treated with open cholecystectomy (OC)at the same term were as OC group.The treatment outcomes of two groups were compared.Results：After treatment,there was no statistical significance between two groups regarding the overall response rate and success rate of operation (P>0.05).The operation time,amount of intraoperative bleeding,recovery time of gastrointestinal tract,hospital stays and incidence of complications in LC group were all obviously less than those in OC group.The difference was statistically significant (P<0.05).Conclusion：For elderly patients with acute cholecystitis,the clinical efficacy of LC is better than that of OC,which has the characteristics of fast recovery,less complications,and high clinical application value.

随着社会的老龄化，老年人的许多脏器功能都在逐步退化，其胆囊结石、胆囊炎的发病率也随年龄在逐年增加[1]。腹腔镜胆囊切除术(laparoscopic cholecystectomy，LC)具有切口小，术后患者恢复快等优势，已成为胆囊切除术的首选治疗方式。但由于老年患者常伴有多种慢性疾病，难以耐受高难度手术，LC治疗老年急性胆囊炎的临床疗效及安全性仍未得到临床的广泛认可[2]，因此老年急性胆囊炎患者临床一般仍以传统开腹胆囊切除术(open cholecystectomy，OC)为主。近年来，随着腹腔镜手术的不断成熟，以及医疗设备的的不断更新，LC已在老年急性胆囊患者中展开[3]。本研究回顾性分析157例老年急性胆囊炎患者的临床资料，总结两种手术方式的临床疗效及并发症发生情况，现报告如下。