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本文引用的文献

1
Laparoscopic cholecystectomy in elderly patients.老年患者的腹腔镜胆囊切除术
J Gastrointestin Liver Dis. 2008 Sep;17(3):309-13.
2
Laparoscopic cholecystectomy for acute cholecystitis in the elderly: is it safe?老年急性胆囊炎的腹腔镜胆囊切除术:安全吗?
Surg Laparosc Endosc Percutan Tech. 2008 Aug;18(4):334-9. doi: 10.1097/SLE.0b013e318171525d.
3
Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum is safe even for high-risk patients.即使对于高危患者,采用二氧化碳气腹的腹腔镜胆囊切除术也是安全的。
Surg Endosc. 2008 Jan;22(1):61-7. doi: 10.1007/s00464-007-9300-2. Epub 2007 Oct 18.
4
Risk factors for conversion to open surgery in patients with acute cholecystitis undergoing interval laparoscopic cholecystectomy.接受间隔期腹腔镜胆囊切除术的急性胆囊炎患者中转开腹手术的危险因素。
Ann Acad Med Singap. 2007 Aug;36(8):631-5.
5
Laparoscopic cholecystectomy in patients aged 80 years and over.80岁及以上患者的腹腔镜胆囊切除术
World J Surg. 2006 Jul;30(7):1204-10. doi: 10.1007/s00268-005-0413-2.
6
Laparoscopic cholecystectomy in the elderly.老年人的腹腔镜胆囊切除术
JSLS. 2005 Oct-Dec;9(4):408-10.
7
Low incidence of retained common bile duct stones using a selective policy of biliary imaging.采用选择性胆道成像策略时胆总管结石残留发生率较低。
Surgeon. 2005 Oct;3(5):352-6. doi: 10.1016/s1479-666x(05)80115-5.
8
Laparoscopic cholecystectomy in the elderly: increased operative complications and conversions to laparotomy.老年人的腹腔镜胆囊切除术:手术并发症增加及中转开腹情况
J Laparoendosc Adv Surg Tech A. 2005 Aug;15(4):379-82. doi: 10.1089/lap.2005.15.379.
9
Risk factors for conversion of laparoscopic cholecystectomy to open cholecystectomy.腹腔镜胆囊切除术转为开腹胆囊切除术的危险因素。
Surg Endosc. 2005 Jul;19(7):905-9. doi: 10.1007/s00464-004-2197-0. Epub 2005 May 4.
10
Outcome of laparoscopic cholecystectomy in patients 80 years and older.
World J Surg. 2004 Aug;28(8):745-8. doi: 10.1007/s00268-004-7378-4. Epub 2004 Aug 3.

老年患者的腹腔镜胆囊切除术

Laparoscopic cholecystectomy in elderly patients.

作者信息

Yetkin Gurkan, Uludag Mehmet, Oba Sibel, Citgez Bulent, Paksoy Inci

机构信息

Second Department of General Surgery, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey.

出版信息

JSLS. 2009 Oct-Dec;13(4):587-91. doi: 10.4293/108680809X1258998404604.

DOI:10.4293/108680809X1258998404604
PMID:20202402
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3030796/
Abstract

BACKGROUND AND OBJECTIVE

In this study, we investigated whether laparoscopic cholecystectomy, a minimally invasive procedure, is advantageous in elderly patients.

METHODS

Data from 595 patients who underwent laparoscopic cholecystectomy between January 2003 and December 2007 were prospectively collected in a database. The patients were separated into 2 groups; patients >70 years of age (group A), and patients <70 years of age (group B). Group A was further divided into 3 subgroups, ages 70 to 74, 75 to 79, and 80 and above. Comparison between the groups was made with Mann-Whitney U and chi-square tests where appropriate.

RESULTS

ASA scores increased in conjunction with increased age (P<0.001). Of patients with an operative time longer than one hour, 26 patients aged 70 or older, and 152 patients aged 69 or younger had no difference with respect to PaCO2 and pH measurements (P>0.05). In patients aged 80 or older, the rates of acute cholecystitis, conversion to open surgery, and postoperative complications were significantly higher than in other groups (P>0.05).

CONCLUSION

We believe that in elderly patients, laparoscopic surgery can be applied safely without further increasing the surgical risks. The complications can be minimized by carefully selecting the patients aged 80 or older and by experienced teams with high technical capabilities operating on such patients.

摘要

背景与目的

在本研究中,我们调查了微创的腹腔镜胆囊切除术对老年患者是否具有优势。

方法

前瞻性收集了2003年1月至2007年12月期间接受腹腔镜胆囊切除术的595例患者的数据,并录入数据库。患者被分为两组;年龄>70岁的患者(A组)和年龄<70岁的患者(B组)。A组进一步分为3个亚组,年龄分别为70至74岁、75至79岁以及80岁及以上。在适当情况下,采用Mann-Whitney U检验和卡方检验对各组进行比较。

结果

美国麻醉医师协会(ASA)评分随年龄增长而升高(P<0.001)。手术时间超过1小时的患者中,26例70岁及以上患者与152例69岁及以下患者在PaCO2和pH测量方面无差异(P>0.05)。80岁及以上患者的急性胆囊炎发生率、转为开腹手术率和术后并发症发生率显著高于其他组(P>0.05)。

结论

我们认为,对于老年患者,腹腔镜手术可以安全实施,而不会进一步增加手术风险。通过仔细挑选80岁及以上患者,并由技术能力高的经验丰富团队为这类患者进行手术,可以将并发症降至最低。