微创医学

目的探讨内镜逆行胰胆管造影术（ERCP）治疗老年人胆总管结石的安全性及有效性。方法收集因胆总管结石在广西医科大学第一附属医院住院并行ERCP治疗的患者的临床资料。并将患者分为三组，A组为年龄≥80岁患者，B组年龄为大于60岁至80岁的患者，C组为年龄18～60岁的患者，比较三组患者ERCP操作种类频率、治疗成功率、取石成功率以及并发症发生率等。结果本研究共纳入236名患者，共行ERCP治疗267次，其中A组20次，B组110次，C组137次操作。A组、B组、C组患者治疗好转率分别为100.0%、99.0%、100.0%，差异无统计学意义；而取石成功率分别为70.6%、75.0%、91.9%，提示年龄大于60岁患者的取石成功率显著低于中青年患者(P＜0.05)。1例患者因感染性休克死亡，但无ERCP操作相关死亡。此外7名患者（B组2例，C组5例）并发术后胰腺炎，1名患者并发术后胆管炎，均治疗好转出院，无术后出血、穿孔等并发症发生。结论在做好术前评估及预防的情况下，应用ERCP治疗老年人胆总管结石是安全，有效的。

ObjectiveTo investigate the efficacy and safety of therapeutic ERCP in the treatment of elderly patients with common bile duct stones. MethodsThe data of elderly patients with pancreaticobiliary diseases and underwent endoscopic retrograde cholangiopancreatography (ERCP) was retrospective analyzed. The elderly patients were divided into three groups. Patients in Group A were older than 80 years , group B were aged 60 to 80 years old , group C were aged 18 to 60 years old. The ERCP operation mode, treatment success rate, complication rate and mortality among the three groups were compared. Result267 times of ERCP were performed to treat 236 common bile duct stones patients.Group A were underwent ERCP operation 20 times, group B were 110 times and group C 137 times of operation. ERCP cured rate among the 3 group were 100%, 99% and 100% respectively, the success rate of stone removing were 70.6%, 75%, 91.9%. ERCP treatment efficiency, postoperative pancreatitis, cholangitis, bleeding and other complications had no significant difference the among three group, no perforation and death caused by ERCP. Seven patients occur pancreatitis (two in group B and five in group C), and one occur cholangitis after operation. ConclusionERCP is safe and effective in the treatment of elderly patients with common bile duct stones under the condition of pre-treatment evaluation and prevention.