Application value of endoscopic retrograde biliary drainage for acute obstructive suppurative cholangitis in the elderly
10.3760/cma.j.cn321463-20210913-00264
- VernacularTitle:经内镜胆道内支架放置术在老年急性梗阻性化脓性胆管炎中的应用价值
- Author:
Qiang GUO
1
;
Kai ZHONG
;
Tiemin JIANG
;
Bo RAN
;
Ruiqing ZHANG
;
Yingmei SHAO
;
Tuerganaili AJI
Author Information
1. 新疆医科大学第一附属医院消化血管外科中心肝胆包虫外科 新疆维吾尔自治区包虫及肝胆疾病临床医学研究中心，乌鲁木齐 830054
- Keywords:
Cholangitis;
Acute obstructive suppurative cholangitis;
Aged;
Endoscopic retrograde biliary drainage
- From:
Chinese Journal of Digestive Endoscopy
2022;39(8):645-649
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and efficacy of endoscopic retrograde biliary drainage (ERBD) for acute obstructive suppurative cholangitis (AOSC) in the elderly.Methods:A retrospective analysis was performed on the clinical data of AOSC patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2018 to January 2020. Patients aged 75 years and over ( n=49) were assigned to the elderly group and patients under 75 years old were assigned to the control group ( n=63). General data, American Society of Anesthesiologists (ASA) grading, procedure-related indicators, incidence of postoperative complications and mortality were compared. Results:There were significant differences in age (82.6±5.1 years VS 64.6±4.5 years, t=19.98, P<0.001), albumin levels (29.1±5.9 g/L VS 34.6±8.8 g/L, t=-3.94, P<0.001) and ASA grade ( χ2=8.37, P=0.015) in the elderly group and the control group . The elderly group were accompanied by more basic diseases, i.e. hypertension [57.14% (28/49) VS 34.9% (22/63), χ2=5.51, P=0.019], coronary heart disease [55.1% (27/49) VS 27.0% (17/63), χ2=9.14, P=0.003], chronic obstructive pulmonary diseases/asthma [24.5% (12/49) VS 6.3% (4/63), χ2=7.41, P=0.006]. There were no significant differences in the operation time (31.4±8.1 min VS 30.4±8.0 min, t=-0.61, P=0.543) or hospital stay (6.1±1.7 days VS 5.7±1.4 days, t=1.35, P=0.182). The incidences of postoperative complications were 14.3% (7/49) in the elderly group and 12.7% (8/63) in the control group, showing no significant difference ( χ2=0.06, P=0.807). No ERBD-related death was observed in either group during hospital stay. Conclusion:For elderly patients with AOSC over 75 years old, emergency ERBD, which can quickly relieve the disease, is safe and effective. Advanced age is not an absolute contraindication for emergency ERBD.
