老年人胆囊切除术后的结果。
Outcome after cholecystectomy in the elderly.
机构信息
Department of Surgery, Division of Abdominal Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Department of Surgery, Division of Abdominal Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
出版信息
Am J Surg. 2019 Aug;218(2):368-373. doi: 10.1016/j.amjsurg.2018.12.018. Epub 2018 Dec 15.
BACKGROUND
Cholecystectomy is considered the standard treatment for acute cholecystitis and symptomatic gallstones. An increasing number of frail elderly patients are being referred for this surgical treatment. A better understanding of surgical outcome in the elderly is needed to improve quality of care.
METHODS
A retrospective analysis of 565 patients who underwent cholecystectomy was performed. Focus of the analyses was on postoperative complications and its predictors.
RESULTS
The study population was divided in two cohorts; aged <70. More complications were found in patients aged ≥70 years. More elderly patients were admitted to the intensive care, respectively 4.0% and 14.1% (P = 0.045). Hospital mortality was 6% in patients aged ≥70 years vs 0.6% in patients <70.
CONCLUSION
In elderly patients, the complication and mortality rate following cholecystectomy is higher than previously reported. For high-risk patients aged ≥70 with cholecystitis, alternative therapies should be considered as a bridge to surgery or definite treatment.
背景
胆囊切除术被认为是治疗急性胆囊炎和有症状胆囊结石的标准治疗方法。越来越多体弱的老年患者被推荐接受这种手术治疗。为了提高护理质量，需要更好地了解老年人的手术结果。
方法
对 565 例接受胆囊切除术的患者进行回顾性分析。分析的重点是术后并发症及其预测因素。
结果
研究人群分为两个队列；年龄<70 岁。≥70 岁的患者并发症更多。更多的老年患者被收入重症监护病房，分别为 4.0%和 14.1%（P=0.045）。≥70 岁的患者的住院死亡率为 6%，而<70 岁的患者为 0.6%。
结论
在老年患者中，胆囊切除术后的并发症和死亡率高于先前的报告。对于患有胆囊炎的≥70 岁的高危患者，应考虑替代疗法作为手术或明确治疗的桥梁。
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