179例80岁以上患者ERCP安全性及疗效分析  

The efficacy and safety of ERCP in 179 elderly patients

作　　者：沈卫东[1] 姚玉玲[1] 吴毓麟[1] 李运红[1] 刘鹏飞[2] 邹晓平[1] 

机构地区：[1]南京大学医学院附属鼓楼医院消化内科,江苏省南京市210008 [2]江阴市人民医院消化科,江苏省江阴市214400

出　　处：《实用老年医学》2011年第6期445-447,共3页Practical Geriatrics

摘　　要：目的分析和探讨内镜逆行胰胆管造影术(ERCP)在>80岁患者中应用的有效性和安全性。方法对2006年6月至2011年4月在本院进行ERCP操作的患者179例进行回顾性分析,记录患者基础疾病、ER-CP操作以及并发症情况,对结果进行统计分析。结果 179例患者进行了212次ERCP操作。其中胆总管结石取石122例,恶性胆道梗阻48例,良性胆道狭窄6例,十二指肠乳头腺瘤3例。ERCP操作成功率为95.5%,取石成功率为99.2%(1例未取出),10例患者采用了预切开术(8.2%),3例十二指肠乳头腺瘤均成功切除,并分别置入胰管及胆管塑料支架。ERCP术后并发症12例,其中术后胰腺炎4例,迟发性出血2例,穿孔1例,死亡3例,高淀粉酶血症2例。结论尽管>80岁患者基础疾病较多,但ERCP在>80岁患者中的应用是安全有效的。Objective To investigate the efficacy and safety of endoscopic retrograde cholangiopancreatography（ERCP）in patients aged 80 years old and over.Methods A total of 179 patients undergoing ERCP procedures between June 2006 and April 2011 were retrospectively studied.Data about clinical and biochemical features,primary diseases,ERCP procedures,ERCP diagnosis,and complications were recorded.Results 179 cases underwent 212 ERCP procedures（122 cases with choledocholithiasis,48 cases with malignant obstruction of biliary tract,6 cases with benign obstruction of biliary tract and 3 cases with adenoma of duodenal papilla）.The overall successful rate of stone extraction was 99.2%.Ten patients underwent pre-cut papillotomy.Three patients received adenoma excision and plastic stent in pancreatic duct and bile duct respectively.Post-procedural complications developed in 14（4.7%）patients（4 cases with pancreatitis,2 cases with delayed bleeding,1 case with pancreatitis,3 cases died,2 cases with hyperamylasemia）.Conclusions ERCP is a safe and effective intervention method in elderly patients.

关 键 词：内镜逆行胰胆管造影 老年人 并发症 疗效 

分 类 号：R657.4[医药卫生—外科学]