Wong K H, Schuman B M
Geriatrics. 1976 Jul;31(7):61-7.
Endoscopic retrograde cholangiopancreatography was performed in 46 patients age 60 or older with various suspected pancreaticobiliary or duodenal diseases. Thirty-one patients (67.4%) had diagnostically satisfactory opacification of a duct system. Pathologic conditions obstruction injection of the contrast medium prevented opacification in eight patients (17.4%). Seven cannulations (15.2%) were technical failures. There was one complication, a Gram-negative septicemia that was successfully treated. The procedure is of value in the geriatric patient because it may provide preoperative evidence of pancreatic or biliary disease that cannot be diagnosed by any other technique. In jaundiced patients, identification of the site of obstruction facilites the surgical approach and thus reduces operating time. If the common bile duct is shown to be patent, the patient is spared exploratory surgery or a prolonged hospital stay for observation. Although a normal pancreatic duct does not exclude cancer of the pancreas, it should influence the physician to search for other explanations for abdomianl pain or weight loss befror proceeding with abdominal surgery.
对46例60岁及以上患有各种疑似胰胆管或十二指肠疾病的患者进行了内镜逆行胰胆管造影术。31例患者（67.4%）的导管系统造影显示诊断结果令人满意。病理情况是，造影剂注射受阻导致8例患者（17.4%）未能显影。7次插管（15.2%）为技术失败。发生了1例并发症，即革兰氏阴性败血症，但已成功治愈。该手术对老年患者有价值，因为它可能提供术前胰腺或胆管疾病的证据，而这些疾病无法通过任何其他技术诊断。在黄疸患者中，确定梗阻部位有助于手术方法的选择，从而减少手术时间。如果显示胆总管通畅，则患者无需进行探查性手术或延长住院时间进行观察。虽然正常的胰管并不能排除胰腺癌，但在进行腹部手术之前，它应该促使医生寻找腹痛或体重减轻的其他原因。
