ERCP治疗70岁以上老年人胆道疾病的临床价值

目的 探讨逆行胰胆管造影术(ERCP)治疗70岁以上老年人胆道梗阻性疾病的临床应用价值.方法 对2001年1月至2007年12月行ERCP胆管引流术治疗的218例老年患者(≥70岁)和189例非老年患者(＜70岁)进行回顾性比较分析.结果 老年组平均年龄为(79±9)岁,非老年组为(56±7)岁.老年组和非老年组的胆管引流成功率分别为96.8%(211/218)和97.4%(184/189);ERCP操作时间分别为(55±30)min和(58±34)min;并发症发生率分别为16.1%(35/218)和13.8%(26/189);病死率分别为1.83%(4/218)和1.06%(2/189),两组间均无统计学差异.但老年组重复行ERCP治疗35例(16.1%),显著高于非老年组的5.8%(11/189).结论 ERCP胆管引流术治疗老年胆道梗阻性疾病具有一定的临床应用价值,是一种创伤小、安全、有效的治疗方法.

Role of ERCP for the management of biliary tract diseases in geriatric patients

Objective To investigate the role of ERCP in geriatric population (≥70 yr) with biliary obstruction.Methods 218 geriatric patients (≥70 yr) and 189 non-geriatric ones ( ＜70 yr) admitted during 2001.1～2007.12 who had undergone biliary drainage by ERCP were retrospectively studied.Results The mean ages in geriatric and non-geriatric group were 79±9 and 56±7 yr,respectively.The success rates of biliary drainage were 96.8% (211/218) and 97.4% (184/189) in geriatric and non-geriatric group,respectively.The procedure time of ERCP was (55±30)rain and (58±34)min in geriatric and non-geriatric group,respectively.The complication rates were 16.1% (35/218) and 13.8% (26/189),respectively.The mortality rates were 1.83% ( 4/218 ) and 1.06% ( 2/189 ),respectively.There were no statistically significant differences between the two groups.However,the re-intervention rates were 16.1% (35/218) in geriatric group,which was significantly higher than that of 5.8% (11/189) in non-geriatric group.Conclusions ERCP was a less invasive,safe and effective treatment option for geriatric patients with bile duct obstruction.