Clinical Effect Analysis Of ERCP Biliary Stent In The Treatment Of Senile Choledocholithiasis

Objective:Objective to investigate the clinical effect of ERCP choledocholithiasis under ERCP for elderly patients with choledocholithiasis who are not suitable for endoscopic lithotomy or surgical treatment.Methods:In December 2017 to 2020 were retrospectively analyzed during October,86 cases of The First Hospital of Jilin University outside Department of Hepatobiliary and pancreatic Surgery of the bile duct under the ERCP biliary stenting treatment in patients with complete clinical medical records,depending on the type of surgery is divided into single support and double stents group,including 41 routine ERCP stent implantation,the double stents implantation under 45 routine ERCP.The correlation variables of perioperative period in the two groups were statistically analyzed to explore the clinical efficacy of biliary stent in the treatment of bile duct stones.Results:There were no significant differences in age,gender,hypertension,diabetes,gallbladder resection and other aspects between the two groups(P > 0.05).There was no significant difference in postoperative amylase between the two groups(P > 0.05).The mean operation time of the single stent group was 48.63±9.47 minutes,and the mean operation time of the double stent group was 59.53±7.96 minutes,and the difference between the two groups was statistically significant(t=5.797,P < 0.05).The median postoperative hospital stay of the single stent group was 3 days,and the median postoperative hospital stay of the double stent group was 4 days,with statistically significant difference between the two groups(Z=2.922,P < 0.05).The average hospitalization cost of the single stent group was 4.36± 10,100 yuan,and the average hospitalization cost of the double stent group was 5.06± 11,800 yuan,and the difference between the two groups was statistically significant(t=2.963,P < 0.05).There was no statistical significance in postoperative complications such as postoperative pancreatitis,hyperamylasemia,perforation,hemorrhage and cholangitis between the two groups(P > 0.05).The biliary blockage rate was 36.6% in the single stent group 6 months after surgery,and 13.3% in the double stent group 6 months after surgery,with statistically significant difference between the two groups(P < 0.05).The success rate of the second complete lithotomy was 63.4% in the single stent group and 84.4% in the double stent group,and the difference between the two groups was statistically significant(P < 0.05).Single stent group of preoperative postoperative in white blood cells,total bilirubin,postoperative gamma GGTP(gamma glutamyl transpeptidase),statistically significant difference(P < 0.05),and on the ratio of neutrophils and lymphocytes,single stents group of preoperative there was no statistically significant difference(P > 0.05),double stents group of preoperative in white blood cells,total bilirubin,gamma-GGTP(gamma glutamyl transpeptidase),neutrophil and lymphocyte ratio,there are statistically significant difference(P < 0.05).Conclusion:1.Biliary stent is effective in the treatment of bile duct stones.2.In the treatment of choledocholithiasis,dual-stent biliary stent implantation is superior to single-stent biliary stent implantation in maintaining higher biliary duct patency rate.3.In the case that choledocholithiasis cannot be completely removed at one time,the stent of bile duct should be placed first for unobstructed drainage,and the success rate of further lithotomy is higher.