塑料支架内引流在老年难取性胆管结石中的应用

目的:回顾性分析在老年性难取性胆总管结石患者中胆道塑料支架置入治疗的安全性和有效性.方法:先行常规逆行性胆胰管造影(ERCP)明确诊断,根据胆管扩张及结石大小情况,行十二指肠乳头括约肌切开后经导丝引导放置胆道塑料支架通畅引流.结果:103例取石困难患者在常规ERCP后置入塑料支架.3-6mo后复查ERCP显示有60例(58.2%)结石成为小结石,经内镜应用网篮取出;13例(12.6%)结石未变化,重新更换支架引流;11例(10.6%)最后行腹腔镜胆囊切除胆管探查取石治疗;16例(15.5%)患者因无特殊不适未复查ERCP,长期行内支架引流.结论:对于老年性难取性胆管结石患者,塑料支架内引流是一种十分有效和相对安全的手术方式.

Application of endoscopic plastic biliary stents in elderly patients with unextractable common bile duct stones

AIM:To evaluate the safety and effectiveness of placement of plastic stents in the common bile duct in the treatment of elderly patients with unextractable common bile duct stones.METHODS:The clinical data for 103 elderly patients with unextractable common bile duct stones who underwent endoscopic retrograde cholangiopancreatography (ERCP) and placement of plastic stents in the bile duct were analyzed retrospectively.RESULTS:After placement of plastic stents in the bile duct,60 patients (58.2%) had small stone fragments that were easily extracted with a balloon and basket;13 patients (12.6%) continued to have large stones and had to received repeat ERCP and long-term stenting;11 patients (10.6%) eventually underwent surgery;and 16 patients (15.5%) did not undergo repeat ERCP and were therefore treated by long-term stent placement.CONCLUSION:Plastic biliary stent placement is a reasonable alternative treatment in patients with unextractable common bile duct stones,especially in elderly patients.