Management of calculous acute cholangitis predominantly under duodenoscope in senile patients / 中国微创外科杂志

ABSTRACT

75 years old) with calculous acute cholangitis were endoscopically treated from May 1998 to June 2005.The endoscopic nasobiliary drainage(ENBD) was firstly performed.After patient's conditions had relieved,basket stone removal,endoscopic common bile duct exploration,or endoscopic retrograde biliary drainage(ERBD) were carried out respectively according to patient's individualized conditions.Results The ENBD was performed successfully in all the 273 patients.Three patients died before further treatment.Out of the remaining 270 patients,complete removal of common bile duct stones was achieved by single-session of emergent endoscopy in 36 patients,and by secondary duodenoscopy in 178 patients.ERBD was carried out in 31 patients.Common bile duct exploration with the combination use of duodenoscopy,laparoscopy,and choledochoscopy was conducted in 25 patients,including a conversion to open surgery in 1 patient.No serious complications were found in all the patients.Conclusions For senile patients with calculous acute cholangitis,emergent ENBD combined with duodenoscopic stone removal is safe and effective.