Efficacy for Elderly Patients with Acute Cholangitis and Common Bile Duct Stones and Risk Factors of ERCP Lithotripsy Failure
This paper investigate the clinical efficacy of elderly patients with acute cholangitis and common bile duct stones treated with endoscopic retrograde cholangiopancreatography (ERCP), and the risk factors of the failure of ERCP operation were analyzed. The clinical data of 123 patients with ERCP was analyzed retrospectively. According to the age, the patients were divided into the elderly group (≥75 years) and non-elderly group (£¼75 years), the data of the clinical characteristics, laboratory findings, ERCP surgical situation, the reason of failure of ERCP operation and related complications were collected. There were 49 cases had secondary organs damage. The frequency of comorbidities was higher than that in the non-elderly group (P£¼0.05). CRP and the hospitalization expenses in the elderly group were higher than that in non-elderly group (P£¼0.05). The one-time stone removal rate was much lower in the elderly group (P£¼0.05), the reason of that was connected with the large common bile duct stones and the emergency ERCP. There was no significant difference in the incidence of postoperative complications between the two groups (P£¾0.05), including hyperamylasemia, pancreatitis, biliary tract infection and hemorrhage. The influence factors of ERCP lithotripsy failure included the large common bile duct stones, stenosis of the common bile duct and duodenal papillary structure abnormalities (small papilla and deviation). The ERCP is safe and effective for elderly with acute cholangitis caused by common bile duct stones, without increasing the incidence of postoperative complications. However, clinicians need to consider the risk factors of the above three ERCP lithotripsy failure.