老年胆道梗阻的特点及治疗

FEATURES AND TREATMENT OF BILE DUCT STRICTURES IN ELDLY PATIENTS

目的 总结老年胆道梗阻性疾病的临床特点、治疗方法及效果。方法 对 1984年 1月至 1999年 9月收治的 6 5岁以上胆道梗阻疾病 15 8例进行回顾性分析。结果 死亡率为 9% (13例 ) ,其中良性梗阻 5例 ,恶性梗阻 8例 ,均死于术后并发症及多器官功能有衰竭。结论 老年胆道梗阻病因复杂 ,病情进展快。强化围手术期治疗 ,预防胆道感染 ,及时有效的胆道引流 ,合理的术式选择 ,是提高治愈率 ,降低并发症及死亡率的关键。经皮经肝穿刺胆管内金属支架放置术对高龄中晚期恶性胆道梗阻的病人是一种安全理想的治疗方法。

Objective To evaluate clinical features and the method of treatment and outcome of bile duct strictures in elderly patients.Method we retrospectively studied the clinical features of bile duct strictures in 158 cases who was more than 65 years and treated from Jan.1984 to Sept.1999.Result The mortality rate of these patients was 9%(13/158).Among the 13 cases,there were 5 cases with benign bile duct strictures,and 8 case with malignant bile duct strictures,respectively.All the patients died of MODS or complication after operation.Conclution Etiology of bile duct strictures in elderly patients was complicated,and the state of the disease was developed fast.We must consolidate the treatment of the disease in perioperation times,including esrly antibiotic therapy and effective drainage in time and appropriate oprative type.All of these are the key to reducing the motality rate and complication in these patients.We believe that radiologically guided trans-cuteneous metal support dilation can manage middle-late of malignant bile duct strictures in elderly patients effetively.