KẾT QUẢ PHẪU THUẬT NỘI SOI ĐIỀU TRỊ VIÊM TÚI MẬT CÁP Ở NGƯỜI CAO TUỔI TẠI BỆNH VIỆN THANH NHÀN

Abstract

Background: The early outcomes of laparoscopic surgery for the management of acute cholecystitis in elderly patients at Thanh Nhan Hospital during the period of 2023-2024 were evaluated. Subjects and methods: A retrospective analysis of 41 elderly patients (aged over 60) diagnosed with cholecystitis and who underwent cholecystectomy at Thanh Nhan Hospital from January 1, 2019, to June 2024 was conducted. The patients were diagnosed with acute gallstone cholecystitis in accordance with the Tokyo Guidelines 2018. Results: The mean age of the patients was 74.8 years (ranging from 60 to 96), with a female-to-male ratio of 1:1.3. The majority of patients, 85.4%, had hypertension. All patients presented with abdominal pain. Additionally, 63.4% had fever, 65.9% showed gallbladder enlargement under the costal margin, and all patients had a positive Murphy's sign. Gallbladder stones were detected in 95.1% of cases through ultrasound. According to the Tokyo Guidelines 2018, 26.8% of patients had mild cholecystitis, 51.2% had moderate severity, and 22.0% had severe severity. Among the patients, 56.1% underwent 1-stage laparoscopic cholecystectomy, while 43.9% received cutaneous gallbladder drainage under ultrasound guidance followed by 2-stage laparoscopic cholecystectomy. In the cohort that underwent gallbladder drainage followed by laparoscopic cholecystectomy, there were no major intraoperative complications, no cases necessitated conversion to open surgery, and no fatalities were reported. The average surgical duration for patients undergoing laparoscopic cholecystectomy was 65.7 ± 16.1 minutes, while for those with gallbladder drainage, it was 49.6 ± 10.8 minutes. The average hospital stay was 8.02 ± 2.12 days for the first cholecystectomy group and 5.24 ± 1.56 days for the gallbladder drainage group. Conclusion: Laparoscopic surgery for acute cholecystitis in elderly patients at Thanh Nhan Hospital is a safe and effective treatment approach, with low complication rates and favorable treatment outcomes.