摘要
目的探讨影响胆总管结石合并十二指肠乳头旁憩室(JPDD)老年患者内镜逆行胰胆管造影术(ERCP)取石的相关因素。方法回顾性分析2019年1月至2022年6月于医院接受ERCP治疗的159例胆总管结石合并JPDD老年患者的临床资料,按照是否一次性取石成功分为成功组(131例)、未成功组(28例)。比较两组基本资料、既往史、术中情况(手术时间、结石、憩室情况等)及ERCP术后情况(住院时间及术后并发症),分析影响胆总管结石合并JPDD老年患者ERCP取石成功的相关因素。结果成功组与未成功组的结石数量、最大结石直径、是否为首次ERCP、手术时间、憩室直径比较,差异有统计学意义(P<0.05)。多因素分析结果显示,多发结石、单个结石直径≥15 mm、非首次行ERCP治疗是影响胆总管结石合并JPDD老年患者ERCP取石成功的相关因素(P<0.05)。结论老年胆总管结石合并JPDD患者ERCP取石成功受多发结石、单个结石直径≥15 mm、非首次行ERCP治疗的影响。可以通过完善术前检查、选取有经验的医生、联合临床先进技术方法等提高ERCP治疗的安全性和有效性。
Objective To explore the related factors that affect ERCP in elderly patients with common bile duct stones and juxtapapillary duodenal diverticulum(JPDD).Methods A retrospective analysis was made of the clinical data of 159 elderly patients with common bile duct stones and JPDD who received ERCP treatment in the hospital from January 2019 to June 2022.They were divided into successful group(131 cases)and unsuccessful group(28 cases)based on whether they were successfully removed at one time.The basic data,past history,intraoperative conditions(surgical time,stones,diverticulum conditions)and postoperative conditions(hospital stay and postoperative complications)of ERCP were compared between the two groups.The relevant factors affecting the success of ERCP stone removal in elderly patients with common bile duct stones and JPDD were analyzed.Results There were statistically differences between the successful and unsuccessful groups in the number of stones,the maximum stone diameter,whether it was the first ERCP,the time of surgery and the diameter of the diverticulum(P<0.05).Multivariate analysis showed that multiple stones,single stone diameter≥15 mm and non-first ERCP treatment were factors affecting the success of ERCP in elderly patients with common bile duct stones and JPDD(P<0.05).Conclusion The success of ERCP in elderly patients with common bile duct stones and JPDD is affected by multiple stones,single stone diameter≥15 mm and non-first ERCP treatment.The safety and effectiveness of treatment can be improved by improving preoperative examinations,selecting experienced physicians and combining advanced clinical techniques and methods.
作者
仝甲钊
曹振振
孙正路
周从顺
魏书堂
TONG Jiazhao;CAO Zhenzhen;SUN Zhenglu;ZHOU Congshun;WEI Shutang(Department of Gastroenterology,the First Affiliated Hospital of Henan University,Kaifeng 475000,China)
出处
《河南医学研究》
CAS
2024年第8期1358-1362,共5页
Henan Medical Research
基金
开封市科技发展计划(2203030)。
关键词
胆总管结石
十二指肠乳头旁憩
老年
内镜逆行胰胆管造影术
common bile duct stones
juxtapapillary duodenal diverticulum
old age
endoscopic retrograde cholangiopancreatography
