Kwon A-Hon, Matsui Yoichi
Department of Surgery, Kansai Medical University, 10-15 Fumizono, Moriguchi, Osaka, 570-8507, Japan.
World J Surg. 2006 Jul;30(7):1204-10. doi: 10.1007/s00268-005-0413-2.
The aging population has led to a significant rise in the number of patients undergoing operations such as cholecystectomy. We have evaluated and compared the results of laparoscopic cholecystectomy (LC) in patients aged 80 years and over with those of patients aged between 65 and 79 years.
A total of 471 patients aged 65 to 79 years (group 1) and 45 patients aged>or=80 years (group 2) underwent LC. All patients underwent preoperative spiral computed tomography after intravenous infusion cholangiography and intraoperative cholangiography.
There was a higher incidence of choledocholithiasis and gallbladder cancer in the patients>or=80 years of age. In addition, group 2 patients had a higher incidence of cardiopulmonary disease and higher American Association of Anesthesiology scores than did those in group 1. With respect to the conversion rate to open surgery, morbidity, mortality, and length of hospital stay, there were no significant differences between the two groups. There was a significantly higher incidence of positive bile cultures and gram-negative rods in group 2 patients than in those in group 1.
Octogenarians tolerated LC well. Therefore, early elective LC should be encouraged to minimize morbidity and mortality in these elderly patients who have symptomatic cholelithiasis.
人口老龄化导致接受胆囊切除术等手术的患者数量显著增加。我们评估并比较了80岁及以上患者与65至79岁患者行腹腔镜胆囊切除术（LC）的结果。
共有471例65至79岁的患者（第1组）和45例年龄≥80岁的患者（第2组）接受了LC。所有患者在静脉注射胆管造影术后均接受了术前螺旋计算机断层扫描及术中胆管造影。
80岁及以上患者胆总管结石和胆囊癌的发病率较高。此外，第2组患者的心肺疾病发病率和美国麻醉医师协会评分高于第1组。在转为开放手术的比率、发病率、死亡率和住院时间方面，两组之间无显著差异。第2组患者胆汁培养阳性和革兰氏阴性杆菌的发病率显著高于第1组。
八旬老人对LC耐受性良好。因此，对于有症状胆结石的老年患者，应鼓励早期择期LC以尽量降低发病率和死亡率。
