CAJ | 학술논문

目的:探讨老年人胆石症伴感染的外科手术治疗经验.方法:回顾性分析1999年1月-2014年12月笔者所在医院接受手术治疗的58例老年胆石症患者的临床资料,总结治疗效果.结果:手术治疗58例老年胆石症急性发作患者,治愈53例(治愈率91.38%),放弃治疗3例,死亡2例(病死率3.45%).其中开腹胆囊切除10例,开腹胆囊切除加胆总管探查取石T管引流15例,肝叶切除、胆囊切除加胆总管切开取石、胆管Roux-en-Y空肠吻合5例,电视腹腔镜胆囊切除10例,电视腹腔镜联合胆道镜胆囊切除、胆总管切开取石T管引流12例,有胆道手术史的6例患者开腹行胆总管切开取石、T管引流.结论:掌握手术适应证和手术时机,重视围手术期处理,处理合并症和基础疾病,采用有效而简单的手术方式和腹腔镜手术,治疗高龄胆石症也同样能取得满意的疗效.
목적:탐토노년인담석증반감염적외과수술치료경험.방법:회고성분석1999년1월-2014년12월필자소재의원접수수술치료적58례노년담석증환자적림상자료,총결치료효과.결과:수술치료58례노년담석증급성발작환자,치유53례(치유솔91.38%),방기치료3례,사망2례(병사솔3.45%).기중개복담낭절제10례,개복담낭절제가담총관탐사취석T관인류15례,간협절제、담낭절제가담총관절개취석、담관Roux-en-Y공장문합5례,전시복강경담낭절제10례,전시복강경연합담도경담낭절제、담총관절개취석T관인류12례,유담도수술사적6례환자개복행담총관절개취석、T관인류.결론:장악수술괄응증화수술시궤,중시위수술기처리,처리합병증화기출질병,채용유효이간단적수술방식화복강경수술,치료고령담석증야동양능취득만의적료효.
Objective:To investigate the experience in the surgical treatment of the elderly cholelithiasis with infection.Method:58 cases of surgical patients were retrospectively analyzed.Result:58 cases elderly cholelithiasis with acute attack underwent the surgical treatment, 53 cases cured(the cure rate was 91.38%),3 cases gave up,and 2 cases died(the mortality was 3.45%).10 cases underwent open cholecystectomy, 15 cases underwent open cholecystectomy and choledocholithotomy T-tube drainage, 5 cases underwent open cholecystectomy and choledocholithotomy T-tube drainage and lobectomy of liver and Roux en Y hepaticojejunostomy,10 cases underwent laparoscopic cholecystectomy, 12 cases underwent laparoscope in combining with choledochoscope to cholecystectomy ,and choledocholithotomy T-tube drainage , 6 cases of patients with a history of biliary tract operation underwent open choledocholithotomy T-tube drainage.Conclusion:Master the operation indications and surgical timing, pay attention to perioperative management,dealing with complications and basic diseases, using effective simple surgical options and laparoscopic surgery,in the treatment of elderly cholelithiasis can also obtain satisfactory curative effect.