老年患者胆总管结石首次行sEST联合EPBD治疗的安全性分析  

The safety study on the first treatment of sEST combined with EPBD in elderly patients with choledocholithiasis

作　　者：陈先志 徐喆[1] 丁升 张健[1] 孙杰[1] 张家泉 王琦[1] 冯其柱 Chen Xianzhi;Xu Zhe;Ding Shen;Zhang Jian;Sun Jie;Zhang Jiaquan;Wang Qi;Feng Qizhu(Department of General Surgery,The First Affiliated Hospital of Anhui University of Science&Technology,Huainan 232007,Anhui,China)

机构地区：[1]安徽理工大学第一附属医院普外科,安徽淮南232007

出　　处：《右江民族医学院学报》2024年第1期85-89,共5页Journal of Youjiang Medical University for Nationalities

基　　金：安徽省教育厅高校自然科学研究基金资助重点项目(KJ2021A0439);淮南市第九批“50.科技之星”创新团队(淮人才办202207号)。

摘　　要：目的探讨老年胆总管结石患者首次行内镜逆行胰胆管造影(ERCP)治疗的临床效果和安全性。方法回顾性分析2019年1月至2023年8月安徽理工大学第一附属医院收治的首次行内镜下逆行胰胆管造影术(ERCP)+内镜下乳头括约肌小切开术(sEST)+内镜下乳头球囊扩张术(EPBD)治疗的胆总管结石患者临床资料。根据患者年龄分为老年组和非老年组,老年组年龄≥70岁,非老年组年龄<70岁。对比两组胆总管结石患者临床资料,分析ERCP+sEST+EPBD治疗老年胆总管结石患者的临床效果和术后并发症。结果老年组患者在年龄、术前合并症、胆总管结石取净率和胆道支架上与非老年组相比差异有统计学意义(P<0.05)。两组术后并发症相比差异无统计学意义(P>0.05),两组术前口服血小板药、插管次数≥2次比较差异有统计学意义(P<0.05)。结论老年患者首次行ERCP+sEST+EPBD治疗胆总管结石是安全的,但胆总管结石取净率低于非老年组。对于术前口服血小板药和插管次数≥2次的患者,需警惕术后并发症的发生。Objective To investigate the clinical effect and safety of the first endoscopic retrograde cholangiopancreatography(ERCP)treatment in elderly patients with choledocholithiasis.Methods Clinical data of patients with choledocholithiasis underwent endoscopic retrograde cholangiopancreatography(ERCP)+endoscopic sphincterotomy(sEST)+Endoscopic papillary balloon dilation(EPBD)for the first time who admitted to the First Affiliated Hospital of Anhui University of Science&Technology from January 2019 to August 2023 were retrospectively analyzed.According to the age of the patients,the patients were divided into the elderly group and the non-elderly group,the age of the elderly group≥70 years old,and the age of the non-elderly group<70 years old.The clinical data of patients with choledocholithiasis were compared between the two groups,and the clinical effect and postoperative complications of ERCP+sEST+EPBD in the treatment of elderly patients with choledocholithiasis were analyzed.Results There were significant differences in age,preoperative comorbidities,choledocholithiasis removal rate,and biliary stent in the elderly group compared with the non-elderly group(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05),and there were statistically significant differences in preoperative oral platelet drugs and intubation times≥2 times between the two groups(P<0.05).Conclusion The first use of ERCP+sEST+EPBD for elderly patients with choledocholithiasis is safe,but the removal rate of choledocholithiasis is lower than that in non-elderly patients.For patients with oral platelet drugs and intubation times≥2 times before surgery,the occurrence of postoperative complications should be noticed.

关 键 词：胆总管结石病 胰胆管造影术 内窥镜逆行 括约肌切开术 内窥镜 老年人 

分 类 号：R364.25[医药卫生—病理学] R575.7[医药卫生—基础医学]