【摘要】 目的探讨高龄胆总管结石患者内镜治疗的疗效和安全性。方法回顾性分析2000年1月-2012年1月我院收治的89例年龄超过80岁的胆总管结石患者,采用逆行胰胆管造影(ERCP)、鼻胆管引流(ENBD)、乳头括约肌切开(EST)及取石术等方法进行内镜下治疗。结果 89例患者均耐受内镜治疗。除7例内镜下治疗失败转手术治疗外,82例内镜下治疗成功,成功率92.1%。其中一次完成EST+网篮取石+ENBD治疗者21例(23.6%);12例乳头括约肌电切时发生渗血,经局部喷洒去甲肾上腺素后出血停止;4例并发术后轻症胰腺炎,1例并发重症胰腺炎,经对症治疗后痊愈。结论内镜治疗高龄胆总管结石患者能够减少并发症、降低死亡率、缩短住院时间,是一种安全有效的治疗方法。更多还原

【Abstract】 Objective To explore the efficacy and safety of endoscopic therapy in elderly patients with choledocholithiasis.Methods A group of 89 patients over 80-year-old were involved in this study from Jan.2000 to Jan.2012 in our hospital.The endoscopic therapy methods included endoscopic retrograde cholangiopancreatography(ERCP),endoscopic nasobiliary drainage(ENBD),endoscopic sphincterotomy(EST) and choledocholithotomy.Results 89 patients tolerated endoscopic therapy.7 cases of endoscopic therapy failed and turned surgical operation,other 82 patients with endoscopic therapy were successful,the successfull rate was 92.1%.21 cases(23.6%) once completed EST+stone basket+ENBD treatment;12 cases of papillary sphincter resection occurred bleeding,the bleeding stopped after spraying norepinephrine.ERCP post-pancreatitis occurred in 5 patients,of which 4 patients were mild and 1 patient was sever,they were cured with the internal medicine expectant treatment.Conclusion Endoscopic therapy has many advantanges included reducing the length of hospital stay,little trauma,safety and effectiveness in the elderly patients with choledocholithiasis.更多还原