Kakucs Tímea, Harsányi László, Kupcsulik Péter, Lukovich Péter
I. Sebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78., 1082.
Orv Hetil. 2016 Jan 31;157(5):185-90. doi: 10.1556/650.2016.30368.
The incidence of cholelithiasis increases with age, however, there is still little data about the outcomes of cholecystectomy in patients with age of 80 and above. Population ageing presents tremendous challenges for surgeons.
The aim of the authors was to compare emergency and elective cholecystectomies performed in these elderly patients.
This retrospective study was based on the analysis of operation type, conversion rate, complications, mortality, length of hospital stay of all patients over 80 who underwent cholecystectomy in the last 6 years at the 1st Department of Surgery, Semmelweis University.
69 elective and 51 emergency operations were performed. In the emergency group pancreatitis was found in 9.8%, liver abscess in 14%, and common bile duct stones in 27% of the patients on admission. Laparoscopic cholecystectomy could be performed in 84% of patients in the elective group, while in 17.7% of patients in the emergency group. The length of stay at the intensive care unit was 9.1 and 1 days, while the total length of hospital stay was 12 and 3.6 days for the elective and emergency groups, respectively. In the emergency group mortality was 20% and reoperation was performed in 16% of patients, while at the elective group none of these occurred.
Laparoscopic cholecystectomy is safe as elective surgery for patients with age of 80 and above. For this reason the authors recommend elective cholecystectomy in this age group.
胆结石的发病率随年龄增长而增加,然而,关于80岁及以上患者胆囊切除术的结果的数据仍然很少。人口老龄化给外科医生带来了巨大挑战。
作者的目的是比较在这些老年患者中进行的急诊和择期胆囊切除术。
这项回顾性研究基于对塞梅尔维斯大学第一外科在过去6年中接受胆囊切除术的所有80岁以上患者的手术类型、转化率、并发症、死亡率、住院时间的分析。
共进行了69例择期手术和51例急诊手术。在急诊组中,入院时9.8%的患者发现胰腺炎,14%的患者发现肝脓肿,27%的患者发现胆总管结石。择期组84%的患者可进行腹腔镜胆囊切除术,而急诊组为17.7%。择期组和急诊组在重症监护病房的住院时间分别为9.1天和1天,总住院时间分别为12天和3.6天。急诊组死亡率为20%,16%的患者进行了再次手术,而择期组未发生这些情况。
腹腔镜胆囊切除术作为80岁及以上患者的择期手术是安全的。因此,作者建议在这个年龄组进行择期胆囊切除术。