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经内镜逆行胰胆管造影治疗60岁以上老年胆胰疾病患者的特点及策略

聂占国 代忠明

引用本文:
Citation:

经内镜逆行胰胆管造影治疗60岁以上老年胆胰疾病患者的特点及策略

DOI: 10.3969/j.issn.1001-5256.2017.04.011
详细信息
  • 中图分类号: R656

Features and strategies of endoscopic retrograde cholangiopancreatography in elderly patients aged above 60 years with biliary and pancreatic diseases

  • 摘要:

    60岁以上老年胆胰疾病患者合并其他基础疾病较多,心肺功能差,多无法耐受全身麻醉,80岁以上患者接受外科胆管探查术的病死率及并发症发生率较高。经内镜逆行胰胆管造影特别适用于老年胆胰疾病患者,阐述了老年患者经内镜逆行胰胆管造影围手术处理及技术操作的特点。

     

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