Analysis of the surgical treatment results for an acute cholecystitis in the senile and elderly patients, depending on term of the operative intervention performance
Objective. To estimate the results of surgical treatment in the senile and elderly patients for an acute cholecystitis on background of biliary calculous disease in urgent abdominal surgery, depending on term of performance of operative intervention.
Materials and methods. In the investigation there were included 89 patients, ageing 60-89 yrs old with diagnosis: an acute cholecystitis on background of biliary calculous disease. Median age of the patients have constituted (69.66 ± 7.30) yrs old.
Results. All the patients were operated in urgent order, average duration of preoperative period was 20.00 (7.00; 27.00) h. Laparoscopic cholecystectomy with abdominal drainage was performed in 70 (78.7%) patients; laparotomy, cholecystectomy with abdominal drainage- in 14 (15.7%); laparotomy, cholecystectomy with drainage of common biliary duct - in 5 (5.6%). In 3 (4.3%) patients while performing of laparoscopic cholecystectomy the necessity have emerged for conversion due to hemorrhage from the gallbladder bed. Preoperative preparation in the senile and elderly patients during more than 24 h have led to significant improvement of their general state, comparing with those, who were operated in terms up to 24 h from the moment of admittance to hospital (U-criterion = 749.50; p = 0.0286). As well, in accordance to data, concerning postoperative period analysis, there was noted significant improvement of the patients’ state, preoperative preparation of whom lasted more than 24 h, comparing with the patients, preoperative preparation of whom lasted lesser than 24 h (U-criterion = 491.00; p < 0.0001). Average duration of stationary stay have differed in this two Groups (U-criterion = 919.00; p = 0.3984).
Conclusion. The surgery deferred performance for an acute cholecystitis in the senile and elderly patients permits to improve the results of postoperative treatment and to reduce the frequency of postoperative complications significantly.
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