十二指肠乳头旁憩室对老年患者ERCP的影响

目的探讨老年人十二指肠乳头旁憩室(PAD)与胆胰疾病的关系及其对ERCP的影响。方法回顾性分析老年病人380例,了解老年人PAD与胆管疾病的关系及对诊疗性ERCP的影响。结果发现老年人PAD患者105例,在老年人中发生率27.63%。本组ERCP插管造影成功率95.23%,并发胆管结石者72例,胆管下段良性狭窄15例;胆胰管及壶腹部肿瘤10例;慢性胰腺炎2例,胆总管乳头瘤1例,均进行了治疗性ERCP。术后并发症:4例出血,1例轻型胰腺炎,3例高淀粉酶血症均经内科治疗好转,无1例死亡。结论 ERCP治疗老年人十二指肠乳头周围憩室合并胆胰疾病的患者是安全有效的,年龄、憩室本身不是ERCP的禁忌证,所有治疗性ERCP的方法均适合高龄患者,疗效也是肯定的。

Effect of periampullary diverticulum on ERCP in elderly patients

Objective To investigate the relationship between periampullary diverticulum （PAD） and pancreatobiliary disease in elderly patients and its effect on ERCP. Methods Clinical data of 380 elderly patients who received ERCP were retrospectively reviewed. The relationship between PAD and biliopancreatic disease and its effect on diagnostic and therapeutic ERCP were analyzed. Results PAD was found in 105 elderlyly patients, with a detective rate of 27.63%. The success rate of ERCP was 95.23%. Among the elderly patients with PAD, 72 had stones in the common bile duct, 15 had benign billiary strictures, 10 had pancreatobiliary carcinoma, 2 had chronic pancreatitis, and 1 had common bile duct papilloma. All patients received therapeutic ERCP. Postoperative complications included 4 cases of mild bleeding, 1 case of mild pancreatitis and 3 cases of hyperamylasemia. These patients were cured and none of them died. Conclusions ERCP is a safe and effective procedure for elderly patients with PAD complicated with biliopancreatic disease. Age and diverticulum are not contraindications for ERCP. All methods of therapeutic ERCP are suitable for elderly patients and can be safely and effectively performed.