Napolitano L, Waku M, Di Bartolomeo N, Aceto L, Innocenti P
Università degli Studi G. D'Annunzio di Chieti, Dipartimento di Scienze Chirurgiche.
G Chir. 2004 Aug-Sep;25(8-9):301-3.
The Authors report 66 cases of patients aged 75 years or older who underwent laparoscopic cholecystectomy: 28 cases presented a clinical picture of acute cholecystitis, 3 cases had associated common bile duct stones. A high percentage of patients had cardiovascular disease: 29 patients presented with cardiopaties, of these 9 cases had a history of myocardial infarction, 31 patients had artheriosclerotic hypertension, associated, in 7 patients with signs of brain ischemia. Five patients were suffering from Parkinson's disease, 7 were carriers of diabetes, 2 had liver cirrosis. Three patients were converted due to extensive presence of adhesions from previous surgery. Morbidity and mortality rates were respectively 12% and 1.5%. The Authors think that laparoscopic technique widens indications and reduces risks of cholecystectomy also in elderly patients.
作者报告了66例年龄在75岁及以上接受腹腔镜胆囊切除术的患者:28例表现为急性胆囊炎的临床症状,3例伴有胆总管结石。相当比例的患者患有心血管疾病:29例有心脏病,其中9例有心肌梗死病史,31例有动脉粥样硬化性高血压,7例伴有脑缺血迹象。5例患有帕金森病,7例患有糖尿病,2例患有肝硬化。3例因既往手术粘连广泛而中转开腹。发病率和死亡率分别为12%和1.5%。作者认为腹腔镜技术扩大了胆囊切除术的适应证,也降低了老年患者的手术风险。