老年人腹腔镜胆囊切除术后近期再手术临床分析 - 中华肝胆外科杂志.pdf

·论著· 老年人腹腔镜胆囊切除术后近期 再手术临床分析：附35例 姜宝飞 张建淮 刘斌 郑向欣 【摘要】 目的 探讨老年人腹腔镜胆囊切除术(LC)后近期再手术的原因及防范措施。方法 回顾性分析1993年1月至2007年9月老年病人LC术后近期再手术的35例临床资料。结果35例 病人经再手术治疗后34例获痊愈，其中再手术后发生并发症11例。分别为切口感染2例、腹腔残余 脓肿1例、肺部感染3例、应激性溃疡2例、胆管炎1例、下肢深静脉血栓形成2例，均予对症处理，1 例于再次手术后第3天死于应激性溃疡。结论重视病史询问、完善术前检查、严格选择适应证、规 范手术操作、适时中转开腹以及针对老年病人的一些特殊措施是减少老年病人LC术后近期再手术 的关键。 【关键词】胆囊切除术，腹腔镜；并发症；再手术 after in clinical of35cases Reoperationshortlylaparoscopiccholecystectomyagedpatients：aanalysis 】lANG Bao-／ei’，ZHANGJian—huai，LlUBin，eta1．’DepartmentofHepatobiliaryPancre· atic First Medical 223000。P．R．China Surgery。Huai7anHospital。NanjingUniversity，Huai’an for To thereasonsand measures [Abstract]Objectiveexplore preventive reoperationshortly after Theclinicaldataof35 laparoscopiccholecystectomy(LC)inagedpatients．Methods agedpa— tients afterLCwere Ofthe35 receivingreoperationshortly retrospectivelyanalyzed．Resultspa— the had tients。34werecuredafter ofwhich reoperation．Elevenpostoperativecomplicationsincluding 2with withabdominalresidual with infeetedincisionalwound，1 abscess，3 infection，2 pulmonary withstress inthe veinsoflower the ulcer，1with with limb．All cholangitis，2thrombogenesisdeep 11caseswere other diedfromstressulceronthethird treated．The expectantly patient day．Conclu— sionThe tOreducerateof afterLCin are attentionto shortly agedpat；。ents keys reoperation