Maekawa T, Yabuki K, Satoh K, Tsumura H, Watabe Y
Department of Surgery, Juntendo Izu Nagaoka Hospital.
Nihon Geka Hokan. 1997 Mar 1;66(1):3-13.
In recent years, an increase in average life expectancy has led to a rapid rise in the number of elderly patients undergoing surgery for acute cholecystitis. We studied the clinical characteristics of elderly patients (aged 75 years of more) undergoing surgery for acute cholecystitis, as compared with those of non-elderly patients (aged less than 75 years) undergoing similar procedures. Twenty-four of the patients were elderly, and 44 were non-elderly.
Echography and abdominal computed tomography (CT) revealed no characteristic findings specific to elderly patients, but a smaller proportion of elderly patients showed a three-layered structure of the gallbladder wall. The leukocyte count on admission was significantly lower in elderly patients than in non-elderly patients. As for therapy, a significantly higher proportion of elderly patients underwent percutaneous transhepatic gallbladder drainage (PTGBD) + cholecystectomy + choledochotomy/choledocholithotomy, as compared with non-elderly patients. In contrast, cholecystectomy alone was performed more frequently in non-elderly patients than in elderly patients. The main postoperative complications were psychic symptoms and respiratory tract infections. The postoperative hospital stay was significantly longer for elderly patients, in part because they requested to remain in the hospital until they were able to perform activities of daily living.
近年来，平均预期寿命的增加导致接受急性胆囊炎手术的老年患者数量迅速上升。我们研究了接受急性胆囊炎手术的老年患者（75岁及以上）的临床特征，并与接受类似手术的非老年患者（年龄小于75岁）进行比较。患者中有24例为老年患者，44例为非老年患者。
超声检查和腹部计算机断层扫描（CT）未发现老年患者特有的特征性表现，但显示胆囊壁三层结构的老年患者比例较小。老年患者入院时的白细胞计数显著低于非老年患者。在治疗方面，与非老年患者相比，接受经皮经肝胆囊引流（PTGBD）+胆囊切除术+胆总管切开术/胆总管结石切除术的老年患者比例显著更高。相比之下，非老年患者单独进行胆囊切除术的频率高于老年患者。主要术后并发症为精神症状和呼吸道感染。老年患者术后住院时间显著更长，部分原因是他们要求住院直到能够进行日常生活活动。
