[关键词] 老年；胆结石症；胆囊切除术；腹腔镜

    [摘 要] 目的 探讨腹腔镜胆囊切除术(LC)在治疗老年胆囊结石中的临床价值。方法 回顾分析老年组180例围手术期的处理，特别是对并存有心血管系统、呼吸系统、糖尿病、肝硬化、急性胆源性胰腺炎等疾病的诊治，以及对手术时机、适应证的选择等，与同期非老年组840例临床资料作统计学分析。结果 172例(95.7%)LC成功，8例中转开腹手术，22例术中心率失常，33例术中出现血压升高或大幅度波动，4例术后引流管短暂胆汁漏，8例术后出现肺部感染。本组病例恢复好，无死亡。结论 虽然老年组LC风险相对较非老年组大，只要重视围手术期处理和监护，把握手术时机和合适的适应证，LC对老年人同样是安全并能获得满意的疗效。

    Clinical analysis of 180 cases of laparoscopic cholecystectomy in aged patients

    NIE Wei, ZHONG Yan-wen, GUO Yu-ming, CHEN Jun

    (Department of ??, Chongqing Municipal Corps Hospital, Chinese People's Armed Police Forces, Chongqing 400061, China)

    Abstract: Objective To evaluate the clinical value of laparoscopic cholecystectomy (LC) in aged patients with cholecystolithiasis. Methods Data from the perioperative management of 180 cases, especially those from comorbidities such as cardiovascular diseases, respiratory diseases, diabetes, cirrhosis, acute biliary pancreatitis, etc. and selection of operation opportunity and indications in the aged group were analyzed retrospectively and compared with those in non-aged group (n = 840). Results Success of LC was achieved in 172 cases (95.7%), but 8 patients underwent open cholecystectomy (OC). Intraoperative arrhythmia, elevated or greatly fluctuated blood pressure, postoperative transient biliary leak, and postoperative pulmonary infection were found in 22, 33, 4, and 8 cases. Satisfactory recovery was found in this group, but no death was found. Conclusion Though there is a high risk in the aged patients, more attention paid to the treatment and care during the perioperative period and proper selection of operation opportunity and indications can result in satisfactory results in aged patients undergoing LC. ......