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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 4
Apr.  2017
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Article Contents

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

DOI: 10.3969/j.issn.1001-5256.2017.04.011
  • Published Date: 2017-04-20
  • Elderly patients with biliary and pancreatic diseases are often complicated by other underlying diseases and have poor cardiopulmonary function, and most of them cannot tolerate general anesthesia. The patients aged above 80 years who have undergone bile duct exploration have high mortality rate and incidence rate of complications. Endoscopic retrograde cholangiopancreatography ( ERCP) is applicable to elderly patients with biliary and pancreatic diseases. This article elaborates on the features of perioperative treatment and technical operation of ERCP in elderly patients.

     

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  • [1]SHEN Y.Experience in the treatment of acute severe cholangitis in elderly patients:an analysis of 176 cases[J].J Hepatobiliary Surg, 2003, 11 (6) :452-454. (in Chinese) 沈焱.老年急性重症胆管炎的治疗体会 (附176例) [J].肝胆外科杂志, 2003, 11 (6) :452-454.
    [2]KOKLFI S, PARLAK E.YUKSEL O, et al.Endoscopic retrograde cholangiopancreatography in the elderly:a prospective and comparative study[J].Age Aging, 2005, 34 (6) :572-577.
    [3]WILLIAMS EJ, TAYLOR S, FAIRCLOUGH P, et al.Risk factors or complication following ERCP:results of a large scale, prospective multi-center study[J].Endoscopy, 2007, 39 (9) :793-801.
    [4]CHENG CL, SHERMAN S, WATKINS JL, et al.Risk factors for post-ERCP pancreatitis:a prospective multicenter study[J].Am J Gastroenterol, 2006, 101 (1) :139-147.
    [5]WU HP.Analysis of clinical value of therapeutic endoscopic retrograde cholangtiopancreatography[J].J Fourth Milit Med Univ, 2009, 30 (6) :552-554. (in Chinese) 吴汉平.治疗性逆行胰胆管造影临床价值分析[J].第四军医大学学报, 2009, 30 (6) :552-554.
    [6]GAO XH.Value of therapeutic endoscopic retrograde cholangiopancreatography in elderly patients with pancreaticobiliary disease[J].Med J Communicat, 2008, 22 (5) :490-493. (in Chinese) 高秀华.治疗性ERCP在老年胆胰疾病中的应用价值[J].交通医学, 2008, 22 (5) :490-493.
    [7]ZHANG PQ, WANG XP, GUO XG, et al.Safety and tolerability of ERCP for elderly patients in diagnose and therapy[J].J Reg Anat Oper Surg, 2014, 23 (5) :508-510. (in Chinese) 张排旗, 王向平, 郭学刚, 等.ERCP用于老年患者诊断和治疗的安全性和耐受性分析[J].局解手术学杂志, 2014, 23 (5) :508-510.
    [8]MONKEMULLER K, FRY LC, MALFERTHEINER P.Gastrointestinal endoscopy in the elderly:current issues[J].Best Pract Res Clin Gastroenterol, 2009, 23 (6) :821-827.
    [9]HAO JF, HU LH, LIAO Z.Safety and efficacy of therapeutic ERCP for patients of over 90 years of age[J].Chin J Dig Endosc, 2012, 29 (10) :558-562. (in Chinese) 郝峻烽, 胡良皞, 廖专.90岁及以上高龄患者行治疗性经内镜逆行胰胆管造影术的安全性与有效性评价[J].中华消化内镜杂志, 2012, 29 (10) :558-562.
    [10]ZHUANG DH, ZHANG K.Operation skills of endoscopic retrograde cholangiopancreatography in pancreaticobiliary patients with periampullary duodenal diverticula[J].J Clin Hepatol, 2016, 32 (9) :1760-1762. (in Chinese) 庄东海, 张锎.合并十二指肠乳头旁憩室的胆胰疾病患者行经内镜逆行胰胆管造影的操作技巧[J].临床肝胆病杂志, 2016, 32 (9) :1760-1762.
    [11]CHENG W, PENG C, JIANG B, et al.Thinking of diagnosis patern of hepatolithiasis[J].Med Philosophy, 2013, 34 (18) :87-89.
    [12]FAN YY, LIN MJ, LIN ZH, et al.Relation between periampullary diverticula and choledocholithiasis and the effect of periampullary diverticula on;removing calculus by endoscopic retrograde cholangiopancreatography[J].Chin Gen Pract, 2016, 19 (9) :1028-1031. (in Chinese) 范燕云, 林梦婕, 林振和, 等.十二指肠乳头旁憩室与胆总管结石的关系及其对经内镜逆行胰胆管造影术取石效果的影响[J].中国全科医学杂志, 2016, 19 (9) :1028-1031.
    [13]KATSINELOS P, CHATZIMAVROUDIS G, TZIOMALOS K, et al.Impact of periampullary diverticula on the outcome and fluoroscopy time in endoscopic retrograde cholangiopancreatography[J].Hepatobiliary Pancreat Dis Int, 2013, 12 (4) :408-414.
    [14]LOBO DN, BALFOUR TW, IFTIKHAR SY, et al.Periampullary diverticula and pancreaticobiliary disease[J].Br J Surg, 1999, 86 (5) :588-597.
    [15]TYAGI P, SHARMA P, SHARMA BC, et al.Periampullary diverticula and technical success of endoscopic retrograde cholangiopancreatography[J].Surg Endosc, 2009, 23 (6) :1342-1345.
    [16] TAO J, SUN H, WANG Z, et al.Surgical treatment for ERCP related duodenal perforations[J].China J Endosc, 2016, 22 (7) :85-89. (in Chinese) 陶杰, 孙昊, 王铮, 等.内镜逆行胰胆管造影相关十二指肠穿孔的外科治疗[J].中国内镜杂志, 2016, 22 (7) :85-89.
    [17]ZHONG HG, MIAO L, JI GZ, et al.Application of transpancreatic septotomy with pancreatic duct stent or guide wire as precutting technique in difficult endoscopic retrograde cholangiopancreatography[J].J Clin Hepatol, 2015, 31 (12) :2070-2072. (in Chinese) 仲恒高, 缪林, 季国忠, 等.经胰管胆胰管隔膜预切开术留置导丝法和胰管支架法在困难性经内镜逆行胰胆管造影中的应用[J].临床肝胆病杂志, 2015, 31 (12) :2070-2072.
    [18]GUO YT, SUN CY, ZHU HT, et al.Application of precut sphincteroctomy in difficulty cannula's endoscopic retrograde cholangiopancreatography[J/CD].Chin J Laparoscopic Surgery:Electronic Edition, 2014, 7 (4) :275-279. (in Chinese) 郭宇廷, 孙诚谊, 朱海涛, 等.十二指肠乳头括约肌预切开术在困难插管ERCP中的应用[J/CD].中华腔镜外科杂志:电子版, 2014, 7 (4) :275-279.
    [19]WANG LM, ZHAO YC, PENG P, et al.Risk factors for postoperative recurrence of choledocholithiasis[J].World Chin J Dig, 2016, 24 (2) :300-304. (in Chinese) 王利民, 赵逸超, 彭鹏, 等.胆总管结石术后复发风险因素[J].世界华人消化杂志, 2016, 24 (2) :300-304.
    [20]BOUSTIERE C.ESGE Guideline:endoscopy and antiplatelet agents therapy during the periendoscopic period[J].Gastrointest Endos, 2011, 43:445-458
    [21]ZHU XY, LIU GF.Management of antithrombotic drugs in patients undergoing digestive endoscopy:an introduction of the ASGE guidelines in 2016[J].Chin J Dig Endosc, 2016, 33 (6) :409-410. (in Chinese) 朱新影, 刘改芳.消化内镜操作患者中抗血栓药物的管理:2016年ASGE指南介绍[J].中华消化内镜杂志, 2016, 33 (6) :409-410.
    [22]WANG JG, WANG DF, DAI N, et al.Conservative treatment of bleeding after endoscopic sphincterotomy[J].Mod Digest Interv, 2003, 8 (2) :97-98. (in Chinese) 王建国, 王冬飞, 戴宁, 等.内镜下十二指肠乳头切开术后出血的保守治疗[J].现代消化及介入诊疗, 2003, 8 (2) :97-98.
    [23]ZHANG YX, HUANG Q, MA JH.Clinical analysis of duodenal papilla hemorrhage after ERCP treated by emergency endoscopic hemostasis (27 cases) [J].China J Endosc, 2016, 22 (2) :83-86. (in Chinese) 张燕霞, 黄茜, 马久红.急诊内镜下治疗内镜下逆行胰胆管造影术后十二指肠乳头出血27例临床分析[J].中国内镜杂志, 2016, 22 (2) :83-86.
    [24]WU LJ, NIE ZG, WANG Y, et al.Causes and treatment of bleeding in patients with pancreaticobiliary disease undergoing endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy[J].Mod Digest Interv, 2011, 16 (1) :58-59. (in Chinese) 吴莉君, 聂占国, 王媛, 等.ERCP及EST治疗胰胆疾病出血原因分析及处理[J].现代消化及介入诊疗, 2011, 16 (1) :58-59.
    [25]HU LH, CHEN P, SHI CL, et al.Diagnosis and treatment of duodenal perforation after endoscopic retrograde cholangiopancreatography:a report of 3 cases[J].Chin J Dig Endosc, 2010, 27 (9) :441-442. (in Chinese) 胡立华, 陈鹏, 石春林, 等.ERCP术后十二指肠穿孔三例诊治[J].中华消化内镜杂志, 2010, 27 (9) :441-442.
    [26]FREEMAN ML, GUDA NM.Prevention of post-ERCP pancreatitis:a comprehensive review[J].Gastrointest Endosc, 2004, 59 (7) :209-216.
    [27]LUO H, ZHAO L, LEUNG J, et al.Routine pre-procedural rectal indomethacin to prevent pancreatitis in patients undergoing endoscopic retrograde cholangiopancreatography:a multicenter, singleblinded, randomised controlled trial[J].Lancet, 2016, 6736 (16) :30312-30319.
    [28]TAO J, SUN H, WANG Z, et al.Surgical treatment for ERCP related duodenal perforations[J].China J Endosc, 2016, 22 (7) :85-89. (in Chinese) 陶杰, 孙昊, 王铮, 等.内镜逆行胰胆管造影相关十二指肠穿孔的外科治疗[J].中国内镜杂志, 2016, 22 (7) :85-89.
    [29]WANG P, LI ZS, LIU F, et al.Risk factors for ERCP-Related complications:a prospective multicenter study[J].Am J Gastroenterol, 2009, 104 (1) :31-40.
    [30]WANG ZH, SU SY, ZHANG G.Clinical application of short 5 Fr pancreatic duct stent in difficult biliary cannulation of ERCP[J].China J Endosc, 2016, 22 (8) :52-56. (in Chinese) 王忠辉, 苏树英, 张耿.短5Fr胰管支架在经内镜逆行胰胆管造影术困难胆管插管中的应用[J].中国内镜杂志, 2016, 22 (8) :52-56.
    [31]ZHANG HM, GUO Q.Efficacy of OTSC closure of acute perforations of the gastrointestinal tract[J].Chongqing Med, 2013, 42 (20) :2349-2351. (in Chinese) 张鹤鸣, 郭强.消化道急性穿孔内镜下OTSC金属夹闭合术效果评估[J].重庆医学, 2013, 42 (20) :2349-2351.
    [32]HOWARD TJ.Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy[J].Ann Surg, 2000, 232 (2) :191-198.
    [33]CHEN YX, LYU NH, CENG CY, et al.Analysis for 9 ERCP-related duodenal perforations[J].China J Endosc, 2013, 19 (2) :170-173. (in Chinese) 陈幼祥, 吕农华, 曾春艳, 等.内镜逆行胰胆管造影并十二指肠穿孔9例分析[J].中国内镜杂志, 2013, 19 (2) :170-173.
    [34]CHEN HX, YUAN CM, LIN GH, et al.Clinical effect of emergency endoscopic retrograde cholangiopancreatography in treatment of acute pyogenic cholangitis in elderly patients[J].China Prac Med, 2016, 11 (27) :142-143. (in Chinese) 陈海昕, 袁楚明, 林贵海, 等.急诊ERCP治疗老年人急性化脓性胆管炎的疗效观察[J].中国实用医药, 2016, 11 (27) :142-143.
    [35]YUE GP.Application of ERCP in patients with acute biliary pancreatitis[J].Sichuan Med, 2012, 33 (6) :943-945. (in Chinese) 岳光平.ERCP在急性胆源性胰腺炎的应用[J].四川医学, 2012, 33 (6) :943-945.
    [36]ZHOU J, YU SM, LUO D.ERCP for acute obstructive suppurative cholangitis in senile patients[J].Med J Natl Defending Forces Southwest China, 2014, 24 (4) :405-408. (in Chinese) 周杰, 余少明, 罗丁.ERCP治疗高龄患者AOSC的临床价值[J].西南国防医药, 2014, 24 (4) :405-408.
    [37]YUAN S, SUN DY.Application of bedside emergency ERCP in the treatment of severe acute biliary pancreatitis[J].World Chin J Dig, 2013, 21 (22) :2217-2220. (in Chinese) 袁帅, 孙大勇.床旁急诊ERCP在重症胆源性胰腺炎治疗中的应用16例[J].世界华人消化杂志, 2013, 21 (22) :2217-2220.
    [38]LU JH, SUN YP, CHEN Q.Application of midazolam combined with propofol on endoscopic retrograde cholangiopancreatography procedure in elder patients[J].J Bengbu Med Coll, 2012, 37 (3) :306-308. (in Chinese) 卢剑华, 孙宜萍, 陈强.咪达唑仑联合丙泊酚麻醉在老年患者内镜下逆行胰胆管造影术中的应用[J].蚌埠医学院学报, 2012, 37 (3) :306-308.
    [39]GONG JP, LIANG X.Clinical observation of penehyclidine hdrochloride in pemedication of ERCP in ederly ptients[J].Med Innov Chin, 2014, 11 (6) :107-109. (in Chinese) 龚建平, 梁秀.生长托宁在老年ERCP麻醉前用药的临床观察[J].中国医学创新, 2014, 11 (6) :107-109.
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