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老年人的胆囊切除术

Cholecystectomy in the elderly.

作者信息

Margiotta S J, Willis I H, Wallack M K

机构信息

Department of Surgery, Mount Sinai Medical Center, Miami Beach, Florida 33139.

出版信息

Am Surg. 1988 Jan;54(1):34-9.

PMID:3337481
Abstract

A two-year retrospective review of 137 patients over 70 years of age undergoing cholecystectomy, from January 1, 1983 to January 1, 1985, was done at Mount Sinai Medical Center of Miami Beach. This study focused on the clinical presentations, surgical management, and overall morbidity and mortality of this operative procedure in the elderly. There were 81 women and 56 men in the study ranging in age from 70 to 96. Elective procedures were performed in (78/137) 57 per cent of the patients while (59/137) 43 per cent underwent emergency surgery. Elective procedures were performed in (55/81) 68 per cent of the women and (23/56) 41 per cent of the men. Emergency surgery was required in (26/81) 32 per cent of the women and (33/56) 60 per cent of the men. Complications developed in (16/78) 20 per cent of the elective cases and (19/59) 32 per cent of the emergency cases. In the elective group, the most common complication involved the cardiovascular system. Sepsis with multiple organ failure accounted for all the deaths in the emergency group. Among the 137 patients in this series, there was a (3/78) 3.8 per cent mortality in the elective group and a (7/59) 12 per cent mortality in the emergency group with an overall mortality of (10/137) 7.3 per cent. The purpose of this study was to highlight the necessity for aggressive surgical management of biliary tract disease in the elderly.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1983年1月1日至1985年1月1日期间,迈阿密海滩西奈山医疗中心对137例70岁以上接受胆囊切除术的患者进行了为期两年的回顾性研究。本研究聚焦于老年人该手术的临床表现、手术管理以及总体发病率和死亡率。研究中有81名女性和56名男性,年龄在70至96岁之间。57%(78/137)的患者接受择期手术,而43%(59/137)的患者接受急诊手术。68%(55/81)的女性和41%(23/56)的男性接受择期手术。32%(26/81)的女性和60%(33/56)的男性需要急诊手术。20%(16/78)的择期病例和32%(19/59)的急诊病例出现并发症。在择期手术组中,最常见的并发症累及心血管系统。脓毒症伴多器官功能衰竭是急诊手术组所有死亡病例的死因。在该系列的137例患者中,择期手术组死亡率为3.8%(3/78),急诊手术组死亡率为12%(7/59),总体死亡率为7.3%(10/137)。本研究的目的是强调积极手术治疗老年人胆道疾病的必要性。(摘要截选至250词)

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