Malik Arshad M, Laghari Abdul Aziz, Talpur K Altaf Hussain, Memon Aisha, Pathan Rafique, Memon Jan Mohammad
Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
J Ayub Med Coll Abbottabad. 2007 Oct-Dec;19(4):45-8.
Advancing age with its associated co-morbidities increases the likelihood of postoperative complications as well as conversion rate during laparoscopic cholecystectomy. Recent studies have also questioned efficacy of this procedure in geriatric patients. The present study assesses the safety and applicability of laparoscopic cholecystectomy in geriatric patients. The objective of the present study was to asses safety and applicability of laparoscopic cholecystectomy in the elderly patients of 65 years and above.
This is a prospective analysis of 173 patients, over 65 years of age, who underwent laparoscopic cholecystectomy from December 2002 to November 2006 at Liaquat University Hospital, Jamshoro. Patients presenting with complicated and uncomplicated gallstone disease were included in the study population and all of them were operated laparoscopically. The data included demographic details, co-morbidities, underlying biliary pathology, indications for surgery, operative and postoperative complications, morbidity and mortality, and hospital stay. The statistical analysis of the data performed on SPSS version 10.
Laparoscopic cholecystectomy undertaken in 173 elderly patients with a mean age of 69.72 years, out of whom 52 (30.05%) were males and 121 (69.94%) were females. Co-morbid conditions were identified in 53.17% (n = 92) patients and included hypertension in 38 patients (21.96%), Diabetes Mellitus in 23 patients (13.29%), COPD in 19 (10.98%) patients, Coronary artery disease in 9 (5.20%) and cardiac arrhythmias in 3 (1.73%) patients. Indications for surgery included simple biliary colic in majority of patients (69.94%) and complicated stone disease in 52 (30.05%) subjects. There were 37 (21.38%) emergency laparoscopic cholecystectomies and 136 (78.61%) patients were operated electively. Mean operative time was 100 minutes with a SD 29.03. Fourteen (8.09%) patients required conversion to OC (Open Cholecystectomy) due to various reasons. Mean hospital stay was 6.28 days. Overall 23 (13.29%) patients developed postoperative complications. One patient died of acute MI on 2nd postoperative day.
There is no undue risk in laparoscopic cholecystectomy in the elderly population and the procedure can be regarded as safe as in patients below 65 years of age.
随着年龄增长及其相关合并症的出现，腹腔镜胆囊切除术期间术后并发症的可能性以及中转开腹率均会增加。近期研究也对该手术在老年患者中的疗效提出质疑。本研究评估腹腔镜胆囊切除术在老年患者中的安全性和适用性。本研究的目的是评估腹腔镜胆囊切除术在65岁及以上老年患者中的安全性和适用性。
这是一项对173例65岁以上患者的前瞻性分析，这些患者于2002年12月至2006年11月在占姆肖罗的利亚卡特大学医院接受了腹腔镜胆囊切除术。患有复杂和非复杂胆结石疾病的患者被纳入研究人群，他们均接受了腹腔镜手术。数据包括人口统计学细节、合并症、潜在胆道病理、手术指征、手术及术后并发症、发病率和死亡率以及住院时间。数据的统计分析使用SPSS 10版进行。
173例老年患者接受了腹腔镜胆囊切除术，平均年龄为69.72岁，其中男性52例（30.05%），女性121例（69.94%）。53.17%（n = 92）的患者存在合并症，包括38例（21.96%）高血压、23例（13.29%）糖尿病、19例（10.98%）慢性阻塞性肺疾病、9例（5.20%）冠状动脉疾病和3例（1.73%）心律失常。手术指征包括大多数患者（69.94%）的单纯胆绞痛和52例（30.05%）患者的复杂结石疾病。有37例（21.38%）急诊腹腔镜胆囊切除术，136例（78.61%）患者接受择期手术。平均手术时间为100分钟，标准差为29.03。14例（8.09%）患者因各种原因需要中转开腹胆囊切除术。平均住院时间为6.28天。总体23例（13.29%）患者出现术后并发症。一名患者在术后第2天死于急性心肌梗死。
老年人群进行腹腔镜胆囊切除术不存在过度风险，该手术可被视为与65岁以下患者一样安全。
