CAJ | 학술논문

目的：总结老年人急性胆囊炎的微创治疗经验。方法回顾性分析2009~2014年采用微创手段治疗老年人急性胆囊炎患者48例的临床资料并进行总结。结果48例急性胆囊炎老年患者中，急诊行腹腔镜胆囊切除术（ LC术）38例，中转开腹1例，无严重并发症；行超声引导下胆囊穿刺引流术（ PTBD术）10例，其中6例3~6个月后择期行LC术，无中转开腹及严重并发症；3例PTBD术后3~6个月拔管观察；1例选择长期带管生存；全组无死亡病例。结论老年急性胆囊炎患者在排除禁忌证的情况下，应争取尽早明确诊断并行微创手术治疗；对于存在治疗禁忌证或错过最佳治疗时机的患者，PTBD术是有效的微创干预手段；合理选择外科干预时机和干预手段、重视围手术期处理可减少和避免并发症的发生。
목적：총결노년인급성담낭염적미창치료경험。방법회고성분석2009~2014년채용미창수단치료노년인급성담낭염환자48례적림상자료병진행총결。결과48례급성담낭염노년환자중，급진행복강경담낭절제술（ LC술）38례，중전개복1례，무엄중병발증；행초성인도하담낭천자인류술（ PTBD술）10례，기중6례3~6개월후택기행LC술，무중전개복급엄중병발증；3례PTBD술후3~6개월발관관찰；1례선택장기대관생존；전조무사망병례。결론노년급성담낭염환자재배제금기증적정황하，응쟁취진조명학진단병행미창수술치료；대우존재치료금기증혹착과최가치료시궤적환자，PTBD술시유효적미창간예수단；합리선택외과간예시궤화간예수단、중시위수술기처리가감소화피면병발증적발생。
Objective The aim of this study is to sum up the experiences of minimally invasive treatment of elderly acute cholecystitis. Methods The clinical data of 48 elderly cases of our hospital with acute cholecystitis treated by minimally invasive method from 2009 to 2014 were retrospectively analyzed. Results In all 48 cases,38 cases received the emergency LC operation,1 case received laparotomy without serious complications,10 cases received ultrasound guided gallbladder puncture drainage( PTBD),6 cases received elective LC 3~6 months later with-out severe complications,3 cases were followed up 3~6 months after PTBD extubation,1 case were treated with tube with long-term survival. No death was reported in whole cases. Conclusion Under the condition of elderly acute cholecystitis patients without contraindications,these patients should be diagnosed at the early phase and received minimally invasive surgery. In the treatment of patients with contraindications or missing the best treatment time,PTBD is effective minimally invasive interventions. During the treatment,selecting reasonable surgical intervention,methods, attaching great importance to the perioperative management can reduce and avoid the occurrence of complications.