内镜下逆行胰胆管造影术治疗老年胆胰疾病

目的观察治疗性内镜下逆行胰胆管造影术在老年胆胰疾病患者中的疗效及并发症,以供临床参考。方法选择笔者所在医院2009年5月～2012年4月收治的老年胆胰疾病患者116例,均行内镜下胰胆管造影术治疗,观察临床治疗效果和术后并发症,并探讨防治措施。结果全部患者中行治疗性内镜下胰胆管造影术成功105例,转为开放手术11例,内镜下胰胆管造影术成功率为90.52%。术后发生急性胰腺炎5例、出血2例、穿孔1例、造影剂反应8例、腹泻3例、急性胆管炎2例、呼吸抑制1例,并发症发生率为18.97%,经对症处理后均痊愈或好转,未发生一例患者死亡。结论治疗性内镜下胰胆管造影术对老年胆胰疾病可起到良好的疗效,加强观察和防治,可减少并发症及其严重后果,在临床应用时应予以重视。

Endoscopic retrograde cholangiopancreatography in the treatment of elderly biliary and pancreatic diseases

Objective To observe the clinical efficacy and complications of endoscopic retrograde cholangiopancreatography in the treatment of elderly biliary and pancreatic diseases,in order to provide a reference for clinical. Methods 116 elderly patients with biliary and pancreatic diseases in the author’s hospital from May 2009 to April 2012 were selected and all were treated by ERCP. Observed the clinical efficacy and complications and explore the control measures. Results 105 cases were successful in the treatments of ERCP, 11 cases were converted to open surgery.The success rate of ERCP was 90.52%. After surgery, there were 5 cases with acute pancreatitis, 2 cases with bleeding, 1 case with perforation, 8 cases with contrast agent reactions, 3 cases with diarrhea, 2 cases with acute cholangitis and 1 case with respiratory depression.The complication rate was 18.97%. After symptomatic treatment, all the patients were cured or improved, no case dead. Conclusion It has good clinical efficacy that ERCP in the treatment of elderly biliary and pancreatic diseases and it can reduce complications and serious consequences if strengthen the surveillance and prevention.The clinical application should be valued.