| Autor: |
Tsuruta, Saroru, Toyoki, Yoshikazu, Yonaiyama, Shinnosuke, Sakuraba, Shingo, Aoki, Kazunori, Kawasaki, Hiroaki, EndoH, Masaaki |
| Jazyk: |
japonština |
| Rok vydání: |
2018 |
| Předmět: |
|
| Zdroj: |
弘前医学. 68(2-4):177-183 |
| ISSN: |
0439-1721 |
| Popis: |
目的：腹腔鏡下胆嚢摘出術（LC）は低侵襲，整容性，術後早期離床，早期退院が可能という利点から広く施行され，高齢者においても有用な治療法だと考えられる．当科での高齢者でのLC の現状，安全性，有用性を検討した． 方法：2011年から2015年に当院で施行したLC 症例553例のうち癌合併例や他手術併施例を除く538例を対象に80歳以上30例を高齢者群，80歳未満508例を非高齢者群とし後方視的に検討した． 結果：高齢者群において背景因子では高血圧および呼吸器疾患合併例，ドレナージ併施例が有意に多く，周術期関連因子では術後外科的，非外科的合併症を有意に多く認めていた．また，術後在院日数は高齢者群で有意に長かった． 結論：80歳以上の高齢LC 症例ではドレナージを要する高度炎症を伴う胆嚢炎が多いことが推測され，術前の全身状態の把握や術中所見を参考にした周術期管理の徹底が必要であると考えられた． Laparoscopic cholecystectomy (LC) is widely performed because less invasiveness and brings better esthetic outcomes and earlier recovery than open cholecystectomy. It is conceivable that LC is effective therapy in elderly patients. We evaluated its efficacy and safety in elderly patients retrospectively. This study involved a total of 538 cases who went through LC in our hospital from 2010 January to 2015 December (except for patients with tumors or other operations). Thirty patients 80 years of age or older belong to the elderly group, and 508 patients less than 80 years belongs to the non-elderly group. Incidence of hypertension, respiratory diseases and biliary drainage history significantly increased in the elderly group than the non-elderly group. In the elderly group, surgical and non-surgical perioperative complications were more frequency observed, and length of postoperative hospital stay was longer. We considered that cholecystitis in elderly tends to accompany a marked inflammatory response requiring biliary drainage. Through evaluation of the preoperative physical status and meticulous perioperative management are necessary in LC of elderly patients. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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