Abstract：Objective: To explore the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of elderly patients with acute cholangitis of severe type (ACST) secondary to common bile duct stones. Methods: The clinical medical records of 105 elderly patients with ACST secondary to common bile duct stones admitted to the hospital from August 2020 to April 2022 were retrospectively reviewed, and according to different surgical procedures, they were divided into observation group (n=73, ERCP) and control group (n=32, laparoscopic choledochal exploration lithotomy). The surgical conditions, clinical efficacy, laboratory indicators, and incidence rates of surgical complications were compared between the two groups. Results: The duration of surgery, average intraoperative bleeding, postoperative hospital stay, and abdominal pain relief time in the observation group were all shorter or less than those in the control group (P<0.05). The levels of serum total bilirubin (TBIL), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were decreased in the two groups at 3 days after surgery compared to before surgery (P<0.05), but there were no statistical differences in the levels of TBIL, ALT and AST between the two groups before and after surgery (P>0.05). Compared with before surgery, the white blood cell count and serum high mobility group box 1 (HMGB1) in the two groups were reduced 3 days after surgery while the proportion of neutrophils was enhanced, and the range of changes in the observation group was greater than those in the control group (P<0.05). There was no statistical significance in the total incidence rate of surgical complications between the two groups (P>0.05). Conclusion: Emergency ERCP has good clinical effects in the treatment of elderly patients with ACST secondary to common bile duct stones. It has the advantages of significantly shortening the surgical time, reducing the intraoperative bleeding volume, rapidly relieving abdominal pain symptoms, alleviating systemic inflammatory reactions, and has certain safety. Therefore, it can be used as the preferred surgical method in clinical practice.
王凯, 张健, 张士伦. 老年人胆总管结石继发急性重症胆管炎患者行急诊ERCP治疗的疗效和安全性分析[J]. 河北医学, 2023, 29(2): 293-298.
WANG Kai, ZHANG Jian, ZHANG Shilun. Efficacy and Safety of Emergency ERCP on Elderly Patients with Acute Cholangitis of Severe Type Secondary to Common Bile Duct Stones. HeBei Med, 2023, 29(2): 293-298.
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2023, Vol. 29 
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