Effectiveness and safety analysis of ERCP in patients aged 90 years and above with large common bile duct stones
ZHANG Daya1, ZHAI Yaqi2, WU Lang2,3, CHEN Shengxin2,3, LI Mingyang2
1. Graduate School of Hainan Medical University, Haikou 571199, China; 2. Department of Gastroenterology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; 3. Graduate School of Chinese PLA General Hospital, Beijing 100853, China
Abstract：Objective To investigate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of patients over 90 years old with large choledocholithiasis (LCBDS) (diameter>1.5 cm). Methods A retrospective study of 28 patients aged over 90 years (senior group) and 46 patients aged 18~64 years (non-senior group) with primitive papillae and LCBDS who underwent therapeutic ERCP at the First Medical Center of the PLA General Hospital from February 2002 to June 2022 was conducted to analyze their clinical characteristics, preoperative examination, ERCP procedures and postoperative complications. Results Higher acute physiology and chronic health evaluation (APACHE-II)、ASA classification (≥3) and acute cholangitis were more common in the senior group (P<0.001). There was no statistically significant difference in the gender ratio, aCCI, stone diameter >2.0 cm, multiple stone, periampullary diverticulum, endoscopic sphincterotomy (EST), endoscopic papillary large balloon dilation (EPLBD), biliary stent or endoscopic nasobiliary drainage between the two groups (P>0.05). The differences in complete stone extraction rate at one time, clinical success rate and postoperative complications rate were not statistically significant between the two groups (P>0.05). Conclusions ERCP is a safe and effective treatment for large choledocholithiasis in patients over 90 years of age.
张大涯, 翟亚奇, 吴浪, 陈升鑫, 李明阳. ERCP治疗90岁以上高龄患者胆总管巨大结石疗效[J]. 武警医学, 2022, 33(11): 950-953.
ZHANG Daya, ZHAI Yaqi, WU Lang, CHEN Shengxin, LI Mingyang. Effectiveness and safety analysis of ERCP in patients aged 90 years and above with large common bile duct stones. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(11): 950-953.
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