80岁以上患者多次行经内镜逆行胰胆管造影的临床特点分析

Clinical characteristics of multiple ERCP procedures in elderly patients aged over 80

目的对80岁以上反复多次行经内镜逆行胰胆管造影(ERCP)患者的临床特点进行分析,评估其安全性和有效性。方法收集2010年7月-2014年12月,在北京军区总医院消化内科至少进行2次以上ERCP的>80岁的患者的临床资料。结果60例患者(男33例,女27例)共完成146次ERCP,其中47例完成2次ERCP,5例完成3次ERCP,5例完成4次ERCP,2例完成5次ERCP,1例完成7次ERCP。2例发生十二指肠乳头括约肌切开术后大出血,1例发生ERCP术后胰腺炎,2例在术后3周内因慢阻肺死亡。结论胆总管结石的反复发作和恶性肿瘤患者生存期的延长是高龄患者反复多次ERCP的原因,整体的有效性和安全性良好,ERCP可以改善高龄胆胰疾病患者的预后。

Objective To analyze the clinical characteristics of patients aged equal to or more than 80 years receiving multiple endoscopic retrograde cholangiopancreatography（ ERCP） procedures and to evaluate the safety and efficacy of ERCP. Methods The clinical data were collected and retrospectively reviewed for patients aged 80 years or older who were admitted to the Gastroenterology Department of Beijing Army General Hospital and underwent ERCP at least twice from July 2010 to December 2014. Results Sixty patients（ male 33,female 27）underwent 146 times of ERCP in total,among which 2 times were performed in 47 patients,3 times in 5 patients,4 times in 5 patients,5times in 2 patients,and 7 times in 1 patient. Postoperative events included hemorrhea after endoscopic sphincterotomy in 2 cases,post- ERCP acute pancreatitis in 1 case,and death within 3 weeks after ERCP in 2 cases due to chronic obstructive pulmonary disease. Conclusion Recurrent common bile duct stones and prolonged survival time of malignant tumor patients are the main reasons for repeated ERCP in elderly patients. As a whole,ERCP shows good safety and efficacy and improves the prognosis in elderly patients with biliopancreatic disorders.