ERCP治疗70岁以上老年人胆道疾病的临床价值

Role of ERCP for the management of biliary tract diseases in geriatric patients

目的探讨逆行胰胆管造影术（ERCP）治疗70岁以上老年人胆道梗阻性疾病的临床应用价值。方法对2001年1月至2007年12月行ERCP胆管引流术治疗的218例老年患者（≥70岁）和189例非老年患者（〈70岁）进行回顾性比较分析。结果老年组平均年龄为（79±9）岁，非老年组为（56±7）岁。老年组和非老年组的胆管引流成功率分别为96．8％（211／218）和97．4％（184／189）；ERCP操作时间分别为（55±30）min和（58±34）min；并发症发生率分别为16．1％（35／218）和13．8％（26／189）；病死率分别为1．83％（4／218）和1．06％（2／189），两组间均无统计学差异。但老年组重复行ERCP治疗35例（16．1％），显著高于非老年组的5．8％（11／189）。结论ERCP胆管引流术治疗老年胆道梗阻性疾病具有一定的临床应用价值，是一种创伤小、安全、有效的治疗方法。

Objective To investigate the role of ERCP in geriatric population （≥70 yr） with biliary obstruction. Methods 218 geriatric patients （ ≥70 yr） and 189 non-geriatric ones （ 〈70 yr） admitted during 2001.1 -2007.12 who had undergone biliary drainage by ERCP were retrospectively studied. Results The mean ages in geriatric and non-geriatric group were 79 ± 9 and 56 ± 7 yr, respectively. The success rates of biliary drainage were 95. 8% （211/218） and 97. 4% （184/189） in geriatric and non-geriatric group, respectively. The procedure time of ERCP was （55 ±30）min and （58 ±34）min in geriatric and non-geriatric group, respectively. The complication rates were 16.1% （35/218） and 13.8% （26/189） , respectively. The mortality rates were 1. 83% （ 4/218 ） and 1. 06% （ 2/189 ）, respectively. There were no statistically significant differences between the two groups. However, the rentervention rates were 16.1% （35/218） in geriatric group, which was significantly higher than that of 5. 8% （ 11/189 ） in non-geriatric group. Conclusions ERCP was a less invasive, safe and effective treatment option for geriatric patients with bile duct obstruction.