Comparison between operation through laparotomy and the endoscope for senile and high risk patients with severe acute cholangitis (report of 84 cases)
- VernacularTitle:高龄重症急性胆管炎患者内镜治疗与外科手术治疗对比观察(附84例报告)
- Author:
Bo YANG
;
Shuren MA
;
Wenping ZHOU
- Publication Type:Journal Article
- Keywords:
acute cholangitis of severe type (ACST);
laparotonry surgery;
endoscopic surgery;
geriatrics
- From:
Medical Journal of Chinese People's Liberation Army
2001;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
objective To evaluate endoscopic surgery for high risk patients over 70 years old with severe acute cholangitis. Methods From October 1991 to October 2003, 84 high risk patients over 70 years old suffering from severe acute cholangitis were included and divided into laparotomy surgery (ST) and endoscopic surgery (ET) group. Results 80 patients were cured. The care rate was 81.2% in ST group and 91.6% in ET group. The mortality rate was lower in ET compared with ST (9.1% vs 18.8%). The rate of complication was reduced from 37.5% in ST group to 13.9% in ET group. The average duration of drainage was reduced from 49.4 days in ST group to 18.6 days in ET group. The total treatment days were shortened from 46.2 days to 22.8 days comparing ST with ET. Conclusions Endoscopic surgery should be the first choice for the senile and high risk patients with severe acute cholangitis. Endoscopic surgery was convenient, with mininal injury, safe and effective, and period of treatment was shortened, especially for elderly or critically ill patients, as well as those with MODS or previous billiary operations.