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[老年患者胆总管结石的外科治疗结果]

[Results of the surgical treatment of common bile duct calculi in aged patients].

作者信息

Pélissier E, Bachour A, Girard J F, Hirsch J P

出版信息

Gastroenterol Clin Biol. 1987 Mar;11(3):232-6.

PMID:3582871
Abstract

One hundred and two patients (median age: 76 years old; range: 70-91) underwent choledocotomy for biliary lithiasis. Seventy patients had at least one risk factor, 31 had at least 2 factors and 12 had 3 or 4 factors. The indication for surgical treatment was based on evolutive complications in 64 cases; an elective operation was performed in 38 cases. Common bile duct lithiasis was present in only 87 cases but associated lesions made a choledocotomy necessary in every case. A choledocoduodenostomy was performed in 40 cases and a choledocojejunostomy in 3 cases. No postoperative complications occurred in 86 patients. Of 16 patients with complications, 2 were fatal being due to hemiplegia and respiratory failure respectively. Two patients had residual lithiasis. Ninety-four patients were followed on a long-term basis (median follow-up time: 6 years): 34 died from underlying diseases, while 60 are still alive. Treatment failures were, in one case, recurrent lithiasis treated by choledocoduodenostomy and, in the other case, biliary anastomosis stenosis. These results show that the surgical treatment of choledocolithiasis does not necessarily increase the mortality rate in the elderly.

摘要

102例患者(中位年龄:76岁;范围:70 - 91岁)因胆石症接受胆总管切开术。70例患者至少有一个危险因素,31例至少有两个危险因素,12例有三个或四个危险因素。手术治疗的指征在64例中基于进展性并发症;38例进行了择期手术。仅87例存在胆总管结石,但相关病变使每例均有必要进行胆总管切开术。40例行胆总管十二指肠吻合术,3例行胆总管空肠吻合术。86例患者无术后并发症发生。16例有并发症的患者中,2例分别因偏瘫和呼吸衰竭死亡。2例有残余结石。94例患者进行了长期随访(中位随访时间:6年):34例死于基础疾病,60例仍存活。治疗失败的情况,一例是经胆总管十二指肠吻合术治疗的复发性结石,另一例是胆肠吻合口狭窄。这些结果表明,胆总管结石的手术治疗不一定会增加老年人的死亡率。

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