超高齢者胆石症に対する治療方針　　８０歳以上の超高齢者胆石症の治療方針

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  • Treatment of Cholelithiasis in Elderly Patients Over the Age of 80 Years

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In recent years, the possibility of medical treatment with little stress and short hospital stay and early social rehabilitation has increased. For example, the treatment of cholelithiasis has changed greatly with the spread of laparoscopic cholecystectomy (LC). From January 1988 to March 2003, we treated a total of 2, 383 cases of gallbladder and common bile duct stones, consisting of 795 cases (75.3%) of gallbladder stones and 588 cases (24.7%) of common bile duct stones. When the cases were classified according to the age group, there were 134 cases in the super-elderly age group, that is, 80 years of age or older, including 118 cases in their 80's and 16 cases in their 90's. The surgical treatment procedure adopted in these 134 patients included open laparotomy in 69 cases (open cholecystectomy in 26 and common bile duct explora-tion in 43), a laparoscopic procedure in 16 cases (LC in eight and common bile duct exploration in eight), EPBD in 17 cases, ESWL in nine cases, PTPBD in six cases, EST in four cases, PTCSL in three cases, and ten drainage tube retention in 10 cases (PTGBD in five and PTBD in five). There were seven hospital deaths, which tended to occur in elderly subjects with serious underlying disease or complications; four of the seven patients had heart failure, two had CRF and one had pneumonia.

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