Early endoscopic therapy for elderly patients with acute severe biliary pancreatitis / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the clinical effects of early endoscopic therapy for elderly patients with acute severe biliary pancreatitis.Methods Ninety-two elderly patients with acute severe biliary pancreatitis were randomly divided into 2 groupsERCP group ( n =43) and non-ERCP group ( n =49).Serum TNF-a,IL-6,IL-8,the recovery time of blood amylase,the duration of abdominal pain,hospitalization,mortality and complications were compared.Results ERCP group showed a greater decrease in serum TNF-α,IL-6 and IL-8 levels than the control group ( 45.16 ± 13.48 ) μg/L v.s.( 176.89 ± 47.35 ) μg/L,(31.76 ± 13.85)μg/L v.s.(68.48 ±24.87) μg/L,(113.39 ±63.78) μg/L v.s.(309.86 ± 117.13)μg/L) (P ＜0.05 ).The duration of abdominal pain,the recovery time of blood amylase and hospitalization in ERCP group were significantly shorter compared to the non-ERCP group [ ( 10.2 ± 1.7 ) d v.s.( 13.2 ±2.4)d,(3.3 ±1.0)dv.s.(5.5 ±1.2)d,(15 ±1.6)dv.s.(20±3.0)d] (P＜0.05),and complication rate of the ERCP group was lower,too (5％ v.s.22％,P ＜ 0.05).Conclusion Early ERCP is safe and highly effective for the elderly patients with acute severe biliary pancreatitis.