Selection Strategy of Elderly Patients with Acute Cholecystitis: Open vs. Laparoscopic Cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Yu , DAI Ruiwu , YAN Yong , YANG Shuojun

General Surgery Center of PLA, General Hospital of Chengdu Military Command, Chengdu 610083, China;

Corresponding author：

Keywords：

Elderly patient; Acute cholecystitis; Cholecystectomy; Laparoscopy

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Objective To study the suitable operation method of elderly patients with acute cholecystitis.
Methods The clinical data of 149 elderly patients with acute cholecystitis were retrospectively analyzed. All patients were divided into two groups according to the operation: open cholecystectomy group (OC group, n=76) and laparoscopic cholecystectomy group (LC group, n=73). Some clinical data were compared in this paper such as operation time, blood loss, length of hospital stay, time of resumption of food, time of intestinal function recovery and complications.
Results No marked difference was found between OC group and LC group about basic data except WBC count and examination of gallbladder by B ultrasound（P＞0.05）. But there were significant difference in operation time, blood loss, time of resumption of food, time of intestinal function recovery, length of hospital stay and complications between OC group and LC group （P＜0.01）.
Conclusion Individualized treatment should be emphasized on elderly patients with acute cholecystitis. Selection of OC or LC to these patients should be based on the clinical condition and taken the safety as the first principle.

Citation： WANG Yu,DAI Ruiwu,YAN Yong,YANG Shuojun. Selection Strategy of Elderly Patients with Acute Cholecystitis: Open vs. Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(7): 563-565. doi: Copy

1.	刘浔阳. 老年人危、急重症急性胆囊炎通向择期手术的桥梁-超声引导下经皮胆囊置管造瘘术 [Ｊ]. 中国普通外科杂志， 2002; 11（2）: 6567.
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3.	王雨，戴睿武，阎勇，等. 老年患者急性结石性胆囊炎的临床特点及相关处理对策的研究(附126例报道) [Ｊ]. 华西医学， 2008； 23（4）: 719720.
4.	冉瑞图. 关于胆囊切除术的几点意见 [Ｊ]. 中国普外基础与临床杂志， 2008； 15（2）： 8182.
5.	黄建勇，赵玉亭，刘建文，等. 急性胆囊炎的腹腔镜治疗 [Ｊ]. 河南外科学杂志, 2007; 13(1): 2425.
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7.	Kane RL, Larie N, Borbas C, et al. The outcomes of elective laparoscopic and open cholecystetomy [Ｊ]. J Am Coll Surg, 1995; 180(2): 136145.
8.	张蕾. 医院内感染的预防措施 [Ｊ]. 中国民康医学, 2008; 20(4): 378.
9.	李晓，戈佳云，崔江云. Mirizzi综合征临床诊治体会（附38例报道） [Ｊ]. 中国普外基础与临床杂志， 2008； 15（7）： 522523.
10.	李留峥，于杰，肖仲贤，等. 困难胆囊切除术160例治疗体会 [Ｊ]. 中国普外基础与临床杂志， 2006； 13（4）： 396397.
11.	秦建民, 张阳德, 万小平，等. 结石嵌顿性胆囊炎的腹腔镜处理 [Ｊ]. 肝胆外科杂志, 1999; 7(5): 352354.
12.	王玉明，张笃，韩明福，等. 几种困难情况下的腹腔镜胆囊切除术 [Ｊ]. 肝胆胰外科杂志, 2000; 12(4): 201203.
13.	李浩，李哲浩，金德. 腹腔镜胆囊切除术中转开腹21例原因分析 [Ｊ]. 中国普外基础与临床杂志， 2006； 13（5）： 539.
14.	田伏洲, 石力, 蔡忠红, 等. PTGD在高龄高危急性胆囊炎中的应用 [Ｊ]. 中国实用外科杂志, 2003; 23(6): 333.

1. 刘浔阳. 老年人危、急重症急性胆囊炎通向择期手术的桥梁-超声引导下经皮胆囊置管造瘘术 [Ｊ]. 中国普通外科杂志， 2002; 11（2）: 6567.
2. 章成舫. 老年人急性胆囊炎临床特点及手术时机的选择 [Ｊ]. 医师进修杂志, 1996; 19(11): 2324.
3. 王雨，戴睿武，阎勇，等. 老年患者急性结石性胆囊炎的临床特点及相关处理对策的研究(附126例报道) [Ｊ]. 华西医学， 2008； 23（4）: 719720.
4. 冉瑞图. 关于胆囊切除术的几点意见 [Ｊ]. 中国普外基础与临床杂志， 2008； 15（2）： 8182.
5. 黄建勇，赵玉亭，刘建文，等. 急性胆囊炎的腹腔镜治疗 [Ｊ]. 河南外科学杂志, 2007; 13(1): 2425.
6. 吴劲松. 腹腔镜胆囊切除术并发症的发生原因及预防对策 [Ｊ]. 中国综合临床, 2004; 20(3): 252253.
7. Kane RL, Larie N, Borbas C, et al. The outcomes of elective laparoscopic and open cholecystetomy [Ｊ]. J Am Coll Surg, 1995; 180(2): 136145.
8. 张蕾. 医院内感染的预防措施 [Ｊ]. 中国民康医学, 2008; 20(4): 378.
9. 李晓，戈佳云，崔江云. Mirizzi综合征临床诊治体会（附38例报道） [Ｊ]. 中国普外基础与临床杂志， 2008； 15（7）： 522523.
10. 李留峥，于杰，肖仲贤，等. 困难胆囊切除术160例治疗体会 [Ｊ]. 中国普外基础与临床杂志， 2006； 13（4）： 396397.
11. 秦建民, 张阳德, 万小平，等. 结石嵌顿性胆囊炎的腹腔镜处理 [Ｊ]. 肝胆外科杂志, 1999; 7(5): 352354.
12. 王玉明，张笃，韩明福，等. 几种困难情况下的腹腔镜胆囊切除术 [Ｊ]. 肝胆胰外科杂志, 2000; 12(4): 201203.
13. 李浩，李哲浩，金德. 腹腔镜胆囊切除术中转开腹21例原因分析 [Ｊ]. 中国普外基础与临床杂志， 2006； 13（5）： 539.
14. 田伏洲, 石力, 蔡忠红, 等. PTGD在高龄高危急性胆囊炎中的应用 [Ｊ]. 中国实用外科杂志, 2003; 23(6): 333.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Selection Strategy of Elderly Patients with Acute Cholecystitis: Open vs. Laparoscopic Cholecystectomy

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