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比较经皮经肝胆囊管球囊扩张术与内镜逆行胰胆管造影术治疗老年胆总管结石: 一项 3 年回顾性研究。

Comparing percutaneous transhepatic papillary balloon dilation with endoscopic retrograde cholangiopancreatography in elderly patients for common bile duct stones: a 3-year retrospective study.

机构信息

Department of Interventional Radiology, Qingdao Municipal Hospital, No. 1 Jiao-Zhou Road, Qingdao, 266000, Shandong, People's Republic of China.

Joint Innovation Laboratory for Intelligent Interventional Procedures, Qingdao, 266000, Shandong, People's Republic of China.

出版信息

Abdom Radiol (NY). 2024 Aug;49(8):2706-2713. doi: 10.1007/s00261-024-04371-z. Epub 2024 May 25.

Abstract

PURPOSE

To assess the safety and effectiveness of PTPBD for CBD stones in the elderly population.

METHODS

Patients aged 60 years or older, who underwent PTPBD or ERCP for CBD stones between January 2021 and December 2023, were included in this study and divided into either the PTPBD group or the ERCP group based on the procedure they underwent. Baseline characteristics, intraoperative and postoperative outcomes were collected and analyzed using SPSS 25.0.

RESULTS

A total of 145 cases were enrolled in the study. In terms of intraoperative complications, one patient in the ERCP group experienced hemorrhaging, while one patient in the PTPBD group experienced acute pain. However, neither of these patients were in a serious condition and only required observation. Stone removal procedures were successfully conducted in approximately 95% of cases in both the PTPBD and ERCP groups (95.8 and 94.8%, respectively; P > 0.999). ERCP failures were observed in one patient with a previous Billroth II anastomosis and two patients with unconventional anatomy of the esophagus and stomach. There was no statistically significant difference in postoperative complications between the PTPBD group and the ERCP group (P > 0.05). The length of hospital stays did not differ between the PTPBD group and the ERCP group (P = 0.537 > 0.05).

CONCLUSION

PTPBD can be used in patients who have complicated anatomical issues that make the ERCP procedure difficult. In comparison, PTPBD is a similarly safe, effective, and minimally invasive technique for extracting CBD stones in elderly patients.

摘要

目的

评估 PTPBD 治疗老年 CBD 结石的安全性和有效性。

方法

本研究纳入了 2021 年 1 月至 2023 年 12 月期间因 CBD 结石接受 PTPBD 或 ERCP 治疗的 60 岁及以上患者,根据所接受的治疗方式将患者分为 PTPBD 组或 ERCP 组。收集并使用 SPSS 25.0 分析两组患者的基线特征、围手术期结局。

结果

本研究共纳入 145 例患者。术中并发症方面,ERCP 组有 1 例患者出现出血,PTPBD 组有 1 例患者出现急性疼痛,但均不严重,仅需观察。两组患者结石清除率均在 95%左右(分别为 95.8%和 94.8%;P>0.999)。ERCP 失败发生在 1 例既往毕Ⅱ式吻合患者和 2 例食管胃非常规解剖患者中。PTPBD 组与 ERCP 组术后并发症发生率无统计学差异(P>0.05)。PTPBD 组与 ERCP 组的住院时间无差异(P=0.537>0.05)。

结论

对于解剖结构复杂导致 ERCP 操作困难的患者,可采用 PTPBD。相比之下,PTPBD 是一种同样安全、有效且微创的提取 CBD 结石的方法,适用于老年患者。

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