Abstract：【Objective】 To explore clinical application effect of different methods of ERCP in the treatment of elderly patients with common bile duct stones. 【Methods】The clinical data of 158 elderly patients (≥ 60 years old) with choledocholithiasis treated with ERCP from June 2013 to May 2016 were analyzed retrospectively. According to the treatment method of ERCP, the patients were divided into two groups: endoscopic sphincterotomy group (EST group,n=68) and LEST+EPBD group (n=90). The operation time, hospitalization time, success rate of lithotomy and the occurrence of short-and long-term complications were observed and recorded in the two groups.【Results】There was no significant difference between the two groups in hospitalization time, success rate, the number of stones, the diameter of stones and the incidence of postoperative complications (mean P>0.05), but the rate of mechanical lithotripsy and operative time in the EST group were significantly higher than those in the LEST+ EPBD group, The lonh-term recurrence rate of stone in the EST group was significantly higher than that in LEST+ EPBD group (P<0.05).【Conclusion】ERCP is a safe and effective method for the treatment of elderly patients with choledocholithiasis. Both EST and LEST+ EPBD can achieve satisfactory results. But compared with EST, LEST+EPBD can preserve the normal anatomical structure and function of sphincter of duodenal papilla and effectively reduce the risk of postoperative complications and reduce the operation time, which is worthy of clinical application.
夏焱, 黄明哲, 樊啸, 戚晓亮, 罗蒙, 楼晓楼. 内镜下乳头括约肌切开与内镜下乳头括约肌小切开联合球囊扩张治疗老年胆总管结石临床疗效分析[J]. 医学临床研究, 2018, 35(5): 833-835.
XIA Yan, HUANG Ming-zhe, FAN Xiao,et al. Clinical Application Effect of Different Methods of ERCP in the Treatment of Elderly Patients with Common Bile Duct Stones. JOURNAL OF CLINICAL RESEARCH, 2018, 35(5): 833-835.
[1] Tao T, Zhang M, Zhang QJ,et al.Outcome of a session of extracorporeal shock wave lithotripsy before endoscopic retrograde cholangiopancreatography for problematic and large common bile duct stones[J].World J Gastroenterol,2017,23(27):4950-4957.
[2] Lakatos L, Mester G, Reti G,et al.Selection criteria for preoperative endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy and endoscopic treatment of bile duct stones: Results of a retrospective, single center study between 1996-2002[J].World J Gastroenterol,2004,10(23):3495-3499.
[3] Garcia CJ, Lopez OA, Islam S, et al. Endoscopic retrograde cholangiopancreatography in the elderly[J].Am J Med Sci,2016(1): 84 -90.
[4] Kawai K, Akasaka Y, Murakami K, et al. Endoscopic sphincterotomy of the ampulla of Voter[J].Gastrointest Endosc,1974,20( 4):148-151.
[5] 徐晓丹, 戴建军, 钱建情, 等. 内镜下十二指肠乳头括肌切开取石术后结石复发的多因素回归分析[J].中华消化内镜杂志, 2011, 3: 160.
[6] Shoji M,Sakuma H,Yoshimitsu Y, et al. Topical nitrate drip infusion using cystic duct tube for retained bile duct stone: A six patients case series[J].World J Gastrointest Surg,2013,5( 6) : 210 -215.
[7] Ding J, Li F, Zhu HY, et al. Endoscopic treament of difficult extrahepatic bile duct stones, EPBD or EST: An anatomic View [J].World J Gastrointest Endosc,2015, 7(3): 274-277.
[8] Guo SB, Meng H, Duan ZJ, et al. Small sphincterotomy combined with endoscopic papillary large balloon dilation vs sphincterotomy alone for removal of common bile duct stones[J].World J Gastroenterol,2014, 20(47): 17962-17969.
[9] Teoh AY, Cheung FK, Hu B, et al. Randomized trial of endoscopic sphincterotomy with balloon dilation versus endoscopic sphincterotomy alone for removal of bile duct stones[J].Gastroenterology,2013,144(2): 341-345.
2018, Vol. 35 
