内镜下乳头大球囊扩张术治疗老年患者胆管结石
Endoscopic papillary large balloon dilation for bile duct stones in elderly patients.
作者信息
Sakai Yuji, Tsuyuguchi Toshio, Sugiyama Harutoshi, Sasaki Reina, Sakamoto Dai, Nakamura Masato, Watanabe Yuuto, Nishikawa Takao, Yasui Shin, Mikata Rintaro, Yokosuka Osamu
机构信息
Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Reina Sasaki, Dai Sakamoto, Masato Nakamura, Yuuto Watanabe, Takao Nishikawa, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan.
出版信息
World J Clin Cases. 2015 Apr 16;3(4):353-9. doi: 10.12998/wjcc.v3.i4.353.
AIM
To investigate whether endoscopic papillary large balloon dilation (EPLBD) can be safety and effectively performed in patients aged ≥ 80 years.
METHODS
Lithotomy by EPLBD was conducted in 106 patients with bile duct stones ≥ 13 mm in size or with three or more bile duct stones ≥ 10 mm. The patients were divided into group A (< 80 years) and group B (≥ 80 years). Procedure success rate, number of endoscopic retrograde cholangiopancreatographies (ERCP), and incidence of complications were examined in both groups.
RESULTS
Group B tended to include significantly more patients with peripapillary diverticulum, hypertension, hyperlipemia, cerebrovascular disease/dementia, respiratory disease/cardiac disease, and patients administered an anticoagulant or antiplatelet agent (P < 0.05). The success rate of the initial lithotomy was 88.7 (94/106)%. The final lithotomy rate was 100 (106/106)%. Complications due to treatment procedure occurred in 4.72 (5/106)% of the patients. There was no significant difference in procedure success rate, number of ERCP, or incidence of complications between group A and group B.
CONCLUSION
EPLBD can be safely performed in elderly patients, the same as in younger patients.
目的
探讨内镜乳头大球囊扩张术（EPLBD）在80岁及以上患者中能否安全有效地实施。
方法
对106例胆管结石直径≥13 mm或有3颗及以上直径≥10 mm胆管结石的患者进行EPLBD取石术。将患者分为A组（<80岁）和B组（≥80岁）。观察两组的手术成功率、内镜逆行胰胆管造影（ERCP）次数及并发症发生率。
结果
B组患者中，乳头周围憩室、高血压、高脂血症、脑血管疾病/痴呆、呼吸系统疾病/心脏疾病患者以及接受抗凝或抗血小板药物治疗的患者明显更多（P<0.05）。首次取石成功率为88.7%（94/106）。最终取石率为100%（106/106）。4.72%（5/106）的患者出现治疗相关并发症。A组和B组在手术成功率、ERCP次数或并发症发生率方面无显著差异。
结论
与年轻患者一样，EPLBD在老年患者中也可安全实施。
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