Analysis Of The Characteristics And Efficacy In The Elderly Patients With Acute Cholecystitis

Objective:To explore the characteristics,pathological changes,diagnosis and treatment effect of elderly patients with acute cholecystitis.Method:To retrospective analyse the 234 patients with acute cholecystitis treated in the Department of Hepatobiliary and Pancreatic surgery of Yanbian hospital between January 1,2016 to December 31,2017.The observation group and the control group were divided according to age.The 154 elderly patients elder or equal to 60 yeas old were selected as the observation group,and 80 patients younger than 60 were used as control group.The clinical data of two groups of patients was compared and analyzed.Results:1.The clinical manifestations and symptoms of the two groups were basically the same,and the history of diabetes,hypertension,coronary heart disease and cerebral infarction in the observation group were all higher than those in the control group,with statistical significance(P<0.05).2.The WBC(12.05±7.415×109/L)of the patients in the control group before treatment was higher than that of the observation group(10.26±5.549x 109/L)(P<0.05).There was no statistical significance between the two groups of aminopherase and bilirubin level(P>0.05).Blood biochemical examination after operation,the concentration of plasma albumin in the observation group was lower than the control group,the difference was statistically significant(P<0.05),and the difference of the residual index was not statistically significant(P>0.05).Before and after treatment,the WBC of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).The plasma albumin level of the elderly patients in the observation group and DLC was significantly higher than that in the control group and ELC patients(P<0.05).3.The proportion of gallbladder wall thickening and bile duct stones in the observation group was higher than that of the control group(66.9%vs 52.5%).There was statistical significance(P<0.05).The effusion and gallbladder perforation in the observation group were more than those in the control group,but the difference was not statistically significant.The conversion rate of laparoscopic cholecystectomy of young patients and elderly patients was 1.3%and 7.8%respectively.There were significant in the days of hospitalization between the patients in the observation group and the control group(P<0.05).4.The incidence of gangrene in the intraoperative and postoperative pathological examination was statistically significant(P>0.05),and the incidence of complications in elderly patients was more than that of young patients;the proportion of hypoproteinemia in the elderly patients with DLC(48.8%)was significantly higher than that of those in ELC(27.9%),and the difference was statistically significant(P=0.019).Conclusion:Elderly patients with acute cholecystitis had more complex past history and more severe gallbladder inflammation than younger patients.The symptoms and signs of elderly patients with acute cholecystitis and blood test results can not completely reflect the severity of the disease.Elderly patients with acute cholecystitis received laparoscopic cholecystectomy earlier,the incidence of postoperative complications and hospitalization time were higher than those of patients undergoing delayed cholecystectomy.