胆囊切除术在成功抽出胆固醇胆病症后,在患有并发病的老年患者中所面临的挑战
Sencan Acar1, Aydin Seref Koksal2, Erkan Parlak2
1Department of Gastroenterology, Istanbul Florence Nightingale Hospital, Abide-i Hurriyet Cad. No: 166. Sisli, Istanbul, Turkey. sencanacar@yahoo.com.
BMC surgery
|December 9, 2025
概括
在老年患者中,内镜逆行性胆管松造影 (ERCP) 用于胆道结石的去除是一种可行的胆囊切除术的替代方案. 这种方法对患有并发病的老年人尤其有益,降低了死亡风险.
科学领域:
- 胃肠病学 胃肠病学
- 肝胆道手术 肝胆道手术
背景情况:
- 胆固醇切除术传统上建议在通过ERCP提取胆固醇结石后进行.
- ERCP可能会减少胆囊切除术的必要性,特别是在老年人群中.
研究的目的:
- 评估使用ERCP进行胆道结石切除的老年患者的预后.
- 为了比较老年和年轻患者之间的结果,他们对胆固醇结石进行了ERCP.
主要方法:
- 2251个ERCP程序的回顾性审查 (2014年1月至2016年1月).
- 对494名用ERCP治疗的胆固醇结石患者的分析.
- 通过电话进行随访,以评估胆囊切除术状态和并发症;182名患者被排除在外.
- 对70岁以下和70岁以上没有进行早期胆囊切除术的患者进行比较.
主要成果:
- 包括90名70岁以下的患者和110名70岁以上的患者没有早期胆囊切除术.
- 在随访期间发生了63例死亡,主要发生在≥70组.
- 伴随性疾病与死亡率的增加有显著的相关性;胆囊疾病不是死亡原因.
结论:
- 胆道结石提取的ERCP为老年患者提供了胆囊切除术的替代方案.
- 这尤其适用于患有并发病,手术风险高或石头复发风险高的老年患者.
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