摘要：目的：研究胆道疾病手术适应证和手术时机，减少术后并发症，降低死亡率。方法：160例60岁以上老年胆道疾病患者全部行外科手术治疗，择期手术87例(54.37%)；急诊手术73例(45.63%)。术前伴随一种并存病88.75%(三种以上并存病20.63%)。结果：术后并发症23.75%，死亡率6.25%,6例ACST术后死于MODF，4例胆道肿瘤衰竭死亡。结论：掌握手术的适应证和手术时机，处理并存病。争取择期手术，避免急诊手术盲目性是外科治疗老年胆道疾病，减少并发症，降低死亡率的关键。

     关键词： 老年病学； 胆道疾病； 胆结石； 外科手术

    The Problems of Indication and Timing of Operation for Surgical Billary Tract Diseases in Elderly Patients

    HU Jian-ping

    (Nanjing Jiangning Hospital, Jiangsu Nanjing 211100, China)

    Abctract： Objective：To study indication and timing of operation in elderly patients with biluary disease in order to decrease postoperative complication and lower mortality.Method： Altogether 160 patients over 60 years old with billary disease were operated on，including 87 cases subjected to elective surgery(54.37%)and 73 cases(45.63%) to emergency surger.The patients had preoperatively concomitant one kind of disease in 88.75%,,and three kinds of diseases in20.63%. Result： Postoperative complication occurred in 23.75% patients and mortality in 6.25%(6 cases of ACST died of MOF and 4 cases, of biluary tract malignant failure). Conclusion： The important factors to decrease the postoperative complication and mortality in treatment of biliary tract diseases in elderly patients are mastering the operative indication and timing, treating concomitant diseases ......