腹腔镜胆囊切除术在高龄腹部手术后患者中的应用

目的]探讨高龄（≥70岁）腹部手术后患者行腹腔镜胆囊切除术（LC）的可行性.方法]回顾性分析31例高龄腹部手术史患者行LC病例资料,避开原有切口选择四戳孔法和三戳孔法,必要时采用开放法置入穿刺鞘,注重腹腔内粘连区的分离技巧.结果]本组31例,其中28例成功完成手术,中转开腹3例,无手术并发症.结论]严格注意适应证,具备熟练的操作技能,有腹部手术史的高龄患者行LC仍是安全可行的.

Clinical Application of Laparoscopic Cholecystectomy in Elderly Patients after Abdominal Surgery

Objective] To explore the feasibility of laparoscopic cholecystectomy（LC） in elderly patients （≥70 years old） after abdominal surgery. Methods] The clinical data of 31 elderly patients with the history of abdominal surgery undergoing LC were analyzed retrospectively. The fourth trocar and three-trocar technique avoiding original incision were chosen. If necessary, opening method was used to insert the trocar. The adhesive tissue was separated skillfully. Results]Of the 31 cases, 28 cases were operated successfully with laparoscopic cholecystectomy, and 3 cases changed to laparotomy. All the patients recovered without any complications. Conclusion] With the perfect skill in operation and assurance of indication, laparoscopic cholecystectomy is safe and efficient in elderly patients after abdominal surgery.