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外科手术治疗不同年龄组阻塞性黄疸患者。

SURGICAL APPROACH FOR TREATMENT OF OBSTRUCTIVE JAUNDICE IN PATIENTS OF DIFFERENT AGE GROUPS.

机构信息

NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE.

出版信息

Wiad Lek. 2023;76(2):339-345. doi: 10.36740/WLek202302114.

Abstract

OBJECTIVE

The aim: Assessment of the effectiveness of using minimally invasive and open methods of bile duct decompression for treatment of obstructive jaundice (OJ) by comparing complications in patients of di!erent age groups.

PATIENTS AND METHODS

Materials and methods: We analyzed the results of surgical treatment of 250 patients with OJ. The patients were assigned to two groups: Group I (n = 100) consisting of young and middle-age patients, and Group II (n = 150) consisting of elderly, senile and long-living patients. The average age was 52 ± 6.0 years.

RESULTS

Results: 62 (24.8%) Group I patients and 74 (29.6%) Group II patients were submitted to minimally invasive surgical interventions. 38 (15.2%) Group I patients and 76 (30.4%) Group II patients were submitted to open surgical interventions. Complications after minimally invasive surgery (n = 62) in Group I patients were observed in 2 (3.2%) cases, and in 4 (10.5%) cases after open surgeries (n = 38). Complications following minimally invasive interventions (n = 74) in Group II patients were registered in 5 (6.8%) cases, and in 9 (11.8%) cases following open operations (n = 76). 2 (2.6%) Group II patients died for transmural myocardial infarction.

CONCLUSION

Conclusions: The use of minimally invasive surgical interventions for treatment of young and middle-aged OJ patients compared to patients of older age groups makes it possible to reduce the frequency of complications by 2.1 times, which is a statistically signi"cant (p <0.05). The frequency of complications after open surgical interventions of bile ducts in patients of di!erent age groups is not statistically signi"cant (p >0.05).

摘要

目的

评估比较不同年龄组患者的并发症,比较微创和开放胆管减压方法治疗梗阻性黄疸(OJ)的疗效。

患者和方法

我们分析了 250 例 OJ 患者的手术治疗结果。患者分为两组:I 组(n=100)由年轻和中年患者组成,II 组(n=150)由老年、高龄和长寿患者组成。平均年龄为 52±6.0 岁。

结果

I 组 62(24.8%)例和 II 组 74(29.6%)例患者接受微创外科干预。I 组 38(15.2%)例和 II 组 76(30.4%)例患者接受开放手术干预。I 组微创手术后(n=62)并发症 2(3.2%)例,开放手术后(n=38)并发症 4(10.5%)例。II 组微创干预(n=74)后并发症 5(6.8%)例,开放手术(n=76)后并发症 9(11.8%)例。II 组 2(2.6%)例患者因透壁性心肌梗死死亡。

结论

与老年患者相比,年轻和中年 OJ 患者采用微创外科干预治疗可使并发症发生率降低 2.1 倍,差异有统计学意义(p<0.05)。不同年龄组患者胆管开放手术后并发症的发生率无统计学意义(p>0.05)。

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