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老年患者单孔腹腔镜胆囊切除术的可行性与安全性:一项单中心回顾性病例系列研究

Feasibility and safety of single-incision laparoscopic cholecystectomy in elderly patients: A single institution, retrospective case series.

作者信息

Wakasugi Masaki, Tanemura Masahiro, Furukawa Kenta, Tei Mitsuyoshi, Suzuki Yozo, Masuzawa Toru, Kishi Kentaro, Akamatsu Hiroki

机构信息

Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.

出版信息

Ann Med Surg (Lond). 2017 Sep 6;22:30-33. doi: 10.1016/j.amsu.2017.08.024. eCollection 2017 Oct.

Abstract

INTRODUCTION

To evaluate the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC) for uncomplicated gallbladder in elderly patients.

MATERIALS AND METHODS

A retrospective analysis of 810 patients undergoing SILC from May 2009 to October 2016 at Osaka Police Hospital was performed, and the outcomes of the patients aged < 80 years and the patients ≥ 80 years were compared.

RESULTS

The median operative times of patients <80 years and patients ≥80 years were 100 min and 110 min, respectively (p = 0.4). The conversion rates to a different operative procedure (multi-port laparoscopic cholecystectomy or open cholecystectomy) were 3% (22/763) of patients < 80 years and 0% of patients ≥ 80 years (p = 0.6). Perioperative complications were seen in 6% (46/763) of patients < 80 years and 17% (8/47) of patients ≥ 80 years (p < 0.05). Pneumonia was seen in 0% (0/763) of patients < 80 years and 4% (3/47) of patients ≥ 80 years (p < 0.05). There was no mortality in either group. The median postoperative hospital stay was 4 days for patients <80 years and 5 days for patients ≥80 years (p < 0.05).

CONCLUSION

SILC for uncomplicated gallbladder could be performed for patients ≥ 80 years with acceptable morbidity and mortality as compared with the previous reports, though the complication rate of patients ≥ 80 years was higher than that of patients < 80 years.

摘要

引言

评估单孔腹腔镜胆囊切除术(SILC)用于老年患者单纯性胆囊疾病的可行性和安全性。

材料与方法

对2009年5月至2016年10月在大阪警察医院接受SILC的810例患者进行回顾性分析,比较年龄<80岁和≥80岁患者的手术结果。

结果

年龄<80岁和≥80岁患者的中位手术时间分别为100分钟和110分钟(p = 0.4)。转为其他手术方式(多孔腹腔镜胆囊切除术或开腹胆囊切除术)的比例,年龄<80岁的患者为3%(22/763),年龄≥80岁的患者为0%(p = 0.6)。围手术期并发症在年龄<80岁的患者中占6%(46/763),在年龄≥80岁的患者中占17%(8/47)(p < 0.05)。年龄<80岁的患者中肺炎发生率为0%(0/763),年龄≥80岁的患者中为4%(3/47)(p < 0.05)。两组均无死亡病例。年龄<80岁患者的术后中位住院时间为4天,年龄≥80岁患者为5天(p < 0.05)。

结论

与既往报道相比,≥80岁患者行单纯性胆囊疾病的SILC,其发病率和死亡率可接受,尽管≥80岁患者的并发症发生率高于<80岁患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a86a/5596353/f012f09e8d77/gr1.jpg

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