do Amaral Paulo Cézar Galvão, Azaro Filho Euler de Medeiros, Galvão Thales Delmondes, Ettinger João Eduardo Marques de Menezes, Silva Reis Jadson Murilo, Lima Marcos, Fahel Edvaldo
General Surgery Division, São Rafael Hospital, Department of Surgery, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.
JSLS. 2006 Oct-Dec;10(4):479-83.
Acute cholecystitis is the major complication of biliary lithiasis, for which laparoscopic treatment has been established as the standard therapy. With longer life expectancy, acute cholecystitis has often been seen in elderly patients (>65 years old) and is often accompanied by comorbity and severe complications. We sought to compare the outcome of laparoscopic treatment for acute cholecystitis with special focus on comparison between elderly and nonelderly patients.
This study was a prospective analysis of 190 patients who underwent laparoscopic cholecystectomy due to acute cholecystitis or chronic acute cholecystitis, comparing elderly and nonelderly patients.
Of 190 patients, 39 (21%) were elderly (>65 years old) and 151 (79%) were not elderly (< or =65 years), with conversion rates of 10.3% and 6.6% (P=0.49), respectively. The incidence of postoperative complications in elderly and nonelderly patients were the following, respectively: atelectasis 5.1% and 2.0% (P=0.27); respiratory infection 5.1% and 2.7% (P=0.6); bile leakage 5.1% and 2.0% (P=0.27), and intraabdominal abscess 1 case (0.7%) and no incidence (P = 1).
According to our data, laparoscopic cholecystectomy is a safe and efficient procedure for the treatment of acute cholecystitis in patients older than 65 years of age.
急性胆囊炎是胆石症的主要并发症，腹腔镜治疗已成为其标准疗法。随着预期寿命的延长，急性胆囊炎在老年患者（>65岁）中较为常见，且常伴有合并症和严重并发症。我们旨在比较急性胆囊炎腹腔镜治疗的结果，特别关注老年患者与非老年患者之间的比较。
本研究对190例因急性胆囊炎或慢性急性胆囊炎接受腹腔镜胆囊切除术的患者进行前瞻性分析，比较老年患者与非老年患者。
190例患者中，39例（21%）为老年患者（>65岁），151例（79%）为非老年患者（≤65岁），其中转率分别为10.3%和6.6%（P=0.49）。老年患者和非老年患者术后并发症的发生率分别如下：肺不张5.1%和2.0%（P=0.27）；呼吸道感染5.1%和2.7%（P=0.6）；胆漏5.1%和2.0%（P=0.27），腹腔内脓肿1例（0.7%）和无发生（P = 1）。
根据我们的数据，腹腔镜胆囊切除术对于治疗65岁以上急性胆囊炎患者是一种安全有效的手术。
