Mackenzie Evangelical Faculty of Paraná, Curitiba, PR, Brazil.
Gastrointestinal Endoscopy Service, 9 of July Hospital, São Paulo, SP, Brazil.
Arq Bras Cir Dig. 2022 Jan 5;34(3):e1607. doi: 10.1590/0102-672020210003e1607. eCollection 2022.
Retrograde endoscopic cholangiopancreatography (ERCP) effectively treats biliary and pancreatic disorders. Its indications are limited and precise, since its misuse delays adequate treatment, increases costs and to patient´s adverse events.
To compare clinical, radiological and exploratory characteristics in relation to therapeutic success in patients undergoing ERCP in relation to age.
421 patients who underwent the method were retrospectively studied; those who were not able to access the duodenal papilla were excluded. The patients were divided into two age groups: <60 years (group 1) and >60 years (group 2), and the variables of gender, examination indications, radiological findings, therapeutic success, diagnosis and the occurrence of immediate adverse events were analyzed.
177 patients were allocated to group 1 and 235 to group 2. The main indication found in both groups was choledocholithiasis. In group 2, the number of cases of acute cholangitis (p=0.001), biliary stenosis (p=0.002) and papilla cancer (p=0.046) was higher. In this group, urgent indication for ERCP was higher (p=0.042), as well as the diagnosis of biliary tract dilatation (p<0.001). The placement of prostheses was the most common procedure performed in both groups, but the greatest number of patients in absolute quantity occurred in group 2. In group 1, the success in catheterization and the chance of achieving clearing of the biliary tract was significantly higher in compared to group 2 (p=0.016, OR=2.1).
The success of catheterization and complete clearance of the bile duct was significantly higher in the group of young patients.
逆行内镜胰胆管造影术（ERCP）有效地治疗胆道和胰腺疾病。它的适应证是有限且精确的，因为其误用会延迟适当的治疗，增加成本，并使患者发生不良事件。
比较行 ERCP 的患者的临床、放射学和探查特征与年龄相关的治疗成功率。
回顾性研究了 421 例接受该方法的患者；排除未能进入十二指肠乳头的患者。将患者分为两个年龄组：<60 岁（组 1）和>60 岁（组 2），分析性别、检查适应证、放射学发现、治疗成功率、诊断和即刻不良事件的发生情况。
177 例患者被分配到组 1，235 例患者被分配到组 2。两组的主要适应证均为胆总管结石。在组 2 中，急性胆管炎（p=0.001）、胆道狭窄（p=0.002）和乳头癌（p=0.046）的病例数较多。在该组中，ERCP 的紧急适应证较高（p=0.042），胆道扩张的诊断也较高（p<0.001）。两组最常见的操作都是放置支架，但绝对数量最多的患者出现在组 2。在组 1 中，与组 2 相比，导管插入术的成功率和胆道清除的机会明显更高（p=0.016，OR=2.1）。
年轻患者的导管插入术成功率和胆管完全清除率明显更高。
