高龄胆胰疾病患者治疗性内镜逆行胰胆管造影的临床特点及并发症分析*

Clinical characteristics and postoperative complications of elderly patients with biliary pancreatic disease treated with ERCP*

摘要:

探讨高龄胆胰疾病患者治疗性内镜逆行胰胆管造影（ERCP）临床特点及术后并发症情况。方法 回顾性分析遵义医学院第三附属医院收治的236例行ERCP治疗的患者临床资料。根据年龄是否超过80岁，分为高龄组和低龄组，探讨高龄患者的临床特点及并发症特点。结果 116例高龄患者中，原发病以胆总管结石为主，但恶性梗阻性黄疸所占比例明显升高，高龄组患者合并高血压病、冠心病、糖尿病、慢性阻塞性肺疾病（COPD）及十二指肠乳头旁憩室发生率明显升高，胆道支架植入术所占比例明显升高，高龄组患者术后出血的发生率明显升高，原发病为恶性梗阻性黄疸、患者合并高血压病、冠心病及十二指肠乳头旁憩室可能是发生术后出血的高危因素。结论 高龄胆胰疾病患者恶性疾病患病率明显升高，常合并高血压病、冠心病、糖尿病、COPD及十二指肠乳头旁憩室，导致术后出血的风险增加。但总体上治疗性ERCP术对高龄胆胰疾病患者安全有效。

Abstract:

To investigate the clinical characteristics and postoperative complications of elderly patients with biliary pancreatic disease treated with endoscopic retrograde cholangiopancreatogra. Methods The clinical data of 236 patients with ERCP were analyzed retrospectively. According to the age of over 80 years or not, the patients were divided into the elderly group and non-elderly group, and the clinical characteristics and complications of elderly patients were explored. Results In 116 cases of elderly patients, the common bile duct stones also were the primary disease, but the proportion of malignant obstructive jaundice was significantly increased. Compared with the non-elderly patients, the incidence of hypertension, coronary heart disease, diabetes mellitus, COPD and duodenal papillary diverticulum were increased significantly in the elderly group. Moreover, the proportion of biliary stent implantation were increased significantly. The incidence of postoperative bleeding in the elderly patients were significantly higher than that in the non-elderly patients, and the high risk factors might be primary malignant obstructive jaundice, with hypertension, coronary heart disease and duodenal papillary diverticulum. Conclusion The prevalence of malignant diseases in elderly patients was increased, and they have a lot of complications, such as hypertension, coronary heart disease, diabetes mellitus, COPD and duodenal papillary diverticulum, which resulting in increased risk of postoperative bleeding. In general, therapeutic ERCP was safe and effective for elderly patients with biliary pancreatic diseases.