Margiotta S J, Horwitz J R, Willis I H, Wallack M K
Department of Surgery, Mount Sinai Medical Center, Miami Beach, Florida 33140.
Am J Surg. 1988 Dec;156(6):509-12. doi: 10.1016/s0002-9610(88)80541-5.
A 4-year retrospective review of 212 patients over 70 years of age who underwent elective and emergency cholecystectomies was undertaken. Elective procedures were performed in 119 patients (76 women, 43 men) whereas 93 patients (43 women, 50 men) underwent emergency surgery. Complications developed in 25 and 34 patients, respectively. In the elective group, the most common complication involved the cardiovascular system, whereas sepsis with multiple organ failure accounted for all of the deaths in the emergency group. Among the 212 patients studied, there was a 3 percent mortality rate in the elective group and a 10 percent mortality rate in the emergency group, with an overall mortality rate of 6 percent. The results indicated that since the risks of elective cholecystectomy are relatively low in the elderly and the risks of cholecystectomy performed as an emergency are considerably higher (10 percent), symptomatic elderly patients with gallstones should be considered good candidates for early elective cholecystectomy.
对212例70岁以上接受择期和急诊胆囊切除术的患者进行了为期4年的回顾性研究。119例患者（76例女性，43例男性）接受了择期手术，而93例患者（43例女性，50例男性）接受了急诊手术。分别有25例和34例患者出现并发症。在择期手术组中，最常见的并发症累及心血管系统，而在急诊手术组中，败血症伴多器官功能衰竭导致了所有死亡病例。在研究的212例患者中，择期手术组的死亡率为3%，急诊手术组的死亡率为10%，总体死亡率为6%。结果表明，由于老年患者择期胆囊切除术的风险相对较低，而急诊胆囊切除术的风险相当高（10%），有症状的老年胆结石患者应被视为早期择期胆囊切除术的合适人选。
