Sequential endoscopic therapy for severe acute cholangitis in eldly patients / 中国普通外科杂志

ABSTRACT

Objective To explore the clinical value of sequential endoscopic therapy(SET) in treating severe acute cholangitis (SAC) in the eldly patients. Methods 38 eldly SAC patients were divided into 2 groupsemergency operation group and SET group. The efficacies in the emergency and stable periods were compared between the two groups. SET consisted endoscopic nasobilliary drainge (ENBD)first; after the disease was controlled, endoscopic sphincterotomy (EST) and stone removing by a basket with netting on top were done, and followed by laparoscopic cholecystectomy (LC) in patients with cholelithiasis in the stable period. Results Compared with the emergency operation group, the mortality of SET group reduced from 21.1%to 5.3%,the rate of complications from 57.9% to 15.8%, the preoperative preparation time was shortened from 12.4 hours to 7.6 hours, postoperative recovery time from 6.5 days to 3.5 days,and the period of total treatment from 45 days to 23 days. Conclusions SET is an ideal alternative for eldly SAC patients,it has minimum injury, effectiveness and shorter treatment course.