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老年人胆囊切除术:一项前瞻性研究。

Cholecystectomy in the elderly: a prospective study.

作者信息

Houghton P W, Jenkinson L R, Donaldson L A

出版信息

Br J Surg. 1985 Mar;72(3):220-2. doi: 10.1002/bjs.1800720327.

Abstract

The mortality and morbidity of 151 elderly patients (greater than 64 years of age) undergoing biliary surgery for benign disease were prospectively studied. The overall mortality was 3.3 per cent. This comprised a 0.77 per cent mortality in the elective group and a 19 per cent mortality in the emergency group. In spite of 77 per cent of the emergency group having a gangrenous gallbladder, a complication difficult to predict preoperatively, the majority of deaths were from cardiovascular disease. The overall incidence of common bile duct exploration was 36 per cent, which was similar in the elective and emergency groups. A comparison between the old (65-74 years) and the aged (over 74 years of age) revealed twice the number of emergency cases in the aged. Considering elective biliary surgery, there was no difference between the mortality, morbidity, or common bile duct exploration rate comparing the old with the aged. This suggests that elective biliary surgery is safe even in the aged.

摘要

对151例因良性疾病接受胆道手术的老年患者(年龄大于64岁)的死亡率和发病率进行了前瞻性研究。总体死亡率为3.3%。其中择期手术组死亡率为0.77%,急诊手术组死亡率为19%。尽管急诊手术组中有77%的患者患有坏疽性胆囊炎,这是一种术前难以预测的并发症,但大多数死亡是由心血管疾病导致的。胆总管探查的总体发生率为36%,在择期手术组和急诊手术组中相似。对年龄较大者(65 - 74岁)和高龄者(74岁以上)进行比较发现,高龄者的急诊病例数是年龄较大者的两倍。考虑择期胆道手术,年龄较大者与高龄者在死亡率、发病率或胆总管探查率方面没有差异。这表明即使是高龄患者,择期胆道手术也是安全的。

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