探讨腹腔镜胆囊切除术应用于高龄患者的有效性及安全性。

回顾性分析2023年1月至2024年12月621例因急性胆囊炎接受胆囊切除术患者的临床资料，按年龄分为高龄组（n=82，年龄≥70岁）和对照组（n=539，年龄<70岁）。使用SPSS 22.0 统计软件进行数据分析，计数资料采用χ²或Fisher精确检验；符合正态分布的计量资料以（

两组患者年龄、体质量指数（BMI）、ASA分级、合并基础疾病[心血管疾病、糖尿病、慢性阻塞性肺疾病（COPD）、肾功能不全]、手术时间、住院天数比较，差异有统计学意义（P<0.05）；高龄组患者术后肺部感染、腹腔感染和总并发症发生率更高、术后住院时间更长（P<0.05）。高龄组合并基础疾病（如心血管疾病、糖尿病）比例更高、ASA 分级更差，可能是其术后肺部感染、腹腔感染发生率升高的重要诱因。多因素分析显示糖尿病、ASA 评分Ⅲ级、手术持续时间>80 min是术后发病率增加的独立危险因素。合并心血管疾病、慢性肾功能不全和住院时间是与出院率独立相关的因素。

在充分评估基础疾病、优化围手术期管理（如控制血糖、选择经验丰富团队缩短手术时间）的前提下，腹腔镜胆囊切除术应用于高龄患者是相对安全的，术后并发症风险可接受。

To investigate the efficacy and safety of laparoscopic cholecystectomy in elderly patients.

Clinical data of 621 patients who underwent cholecystectomy for acute cholecystitis from January 2023 to December 2024 were retrospectively analyzed. Patients were divided into an elderly group (n=82, age ≥70 years) and a control group (n=539, age <70 years). Statistical analysis was performed using SPSS 22.0 software. Categorical data were analyzed using the χ² test or exact test. Normally distributed continuous data were presented as (

There were significant differences between the two groups in age, body mass index (BMI), ASA classification, comorbidities [cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), renal insufficiency], operation time, and length of hospital stay (P<0.05). The elderly group had higher incidences of postoperative pulmonary infection, intra-abdominal infection, and overall complications, as well as a longer postoperative hospital stay (P<0.05). The higher proportion of comorbidities (e.g., cardiovascular disease, diabetes mellitus) and poorer ASA classification in the elderly group may be important contributors to the increased incidence of postoperative pulmonary and intra-abdominal infections. Multivariate analysis showed that diabetes mellitus, ASA grade Ⅲ, and operation duration >80 minutes were independent risk factors for increased postoperative morbidity. Cardiovascular disease, chronic renal insufficiency, and length of hospital stay were factors independently associated with discharge rate.

Laparoscopic cholecystectomy is relatively safe in elderly patients under the premise of adequate evaluation of comorbidities and optimized perioperative management (such as blood glucose control and shortening operation time by an experienced surgical team). The risk of postoperative complications is acceptable.