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目的:评价治疗性ERCP在高龄患者(≥75岁)中的应用价值;探讨高龄患者围手术期及并发症的处理。方法:对所有患者先行积极的术前准备,有心肺系统现症者予以有效的治疗。在完成ERCP检查后,根据病情决定治疗方案。结果:51例患者共完成治疗49例次,成功率96.08%。其中各部位恶性肿瘤22例,胆道系统结石19例,胆囊术后综合征5例,Oddi氏括约肌功能障碍3例。进行乳头括约肌切开(EST)加取石13例,单纯EST治疗胆囊术后综合症或SOD8例。内支架植入术(ERBD)12例。鼻胆管引流术(ENBD)16例。本组无严重的并发症及死亡发生;结论:经过积极的术前准备和仔细、周到的术中监护及操作,治疗性ERCP对高龄患者是安全有效的。
Objective: To evaluate the clinical value of therapeutic ERCP in elderly patients (≥75 years) and to discuss the treatment of perioperative complications in elderly patients. Methods: For all patients before the positive preparation, there are patients with cardiopulmonary disease who are to be effective treatment. After the completion of ERCP examination, according to the condition decided treatment. Results: 51 patients completed a total of 49 cases of treatment, the success rate of 96.08%. Among them, 22 cases were malignant tumor, 19 cases were biliary system stones, 5 cases were post-gallbladder syndrome and 3 cases were Oddi sphincter dysfunction. Thirteen patients underwent open sphincterotomy (EST) and stone extraction, and EST alone was used to treat 8 cases of postoperative gallbladder syndrome or SOD. Stent implantation (ERBD) in 12 cases. Nasobiliary drainage (ENBD) in 16 cases. No severe complications and death occurred in this group. CONCLUSION: Therapeutic ERCP is safe and effective in elderly patients after positive preoperative preparation and careful and considerate intraoperative monitoring and operation.