胆道塑料支架置入术治疗高龄胆总管结石

Treatment of elder patients with common bile duct stones using endoscopic biliary plastic stent

目的评价内镜下胆道塑料支架置入术治疗高龄胆总管结石患者的效果。方法回顾性分析2008年1月至2010年12月于我院行内镜下胆道塑料支架置入术的41例高龄胆总管结石患者(70～93岁)的临床资料。结果本组41例患者中均顺利完成内镜下胆道塑料支架置入术,术后5 d复查肝功能较入院时明显好转,术后每3个月行ERCP检查,根据结石变化情况,决定行取石或更换塑料支架治疗。经平均2.5次内镜下治疗,82.9%(34/41)患者结石取净。平均随访时间21个月(8～40个月),未发生与ERCP或留置支架相关的严重并发症。结论内镜下胆道塑料支架置入术是治疗高龄胆总管结石患者安全、有效并且微创的方法。

Objective To evaluate the efficacy of plastic stents in the treatment of common bile duct （CBD） stones in elder patients. Methods Between January 2008 and December 2010, endoscopic retrograde biliary drainage （ ERBD ） was performed in 41 elder patients （70 - 93 years） admitted our hospital for common bile duct （CBD） stones. The clinical data about therapies and recovery of the patients were recorded and analyzed. Results All 41 patients underwent ERBD successfully. Liver function of the patients improved significantly 5 d after ERBD. Every 3 months after stent placement endoscopic retrograde cholangiopancreatography （ERCP） was performed to revealed conditions of stones left in the CBD and according to ERCP, endoscopic stone extraction or stent replacement was selected. During mean follow-up period of 21 months （range, 8 -40 months）, 82.9%（34/41） CBD stones were eventually cleared up through average 2.5 ERCPs and there were no severe complications related to ERCP or stent placement. Conclusion ERBD is a safe, effective and minimally invasive therapeutic method in the treatment of CBD stones in elder patients.