Clinical Effect Of Endoscopic Papillary Balloon Dilatation In Elderly Patients With Common Bile Duct Stones

ObjectiveTo investigate the clinical effect of endosco pic papillary balloon dilatation（EPBD）in elderl y patients with common bile duct stones（CBDS）.MethodsA total of 128 patients aged ≥60 years old who underwent ERCP lithotom y in The Third People ’s Hospital of Bengbu from January 2017 to December 2019 we re collected and arranged,and classified into observation group（n=61）and control group（n=67）according to different lithotom y methods.the control group used small endoscopic sphincterotomy combined with endoscopic papillary balloon dilation（s EST+EPBD）,the observation group is purely for the endoscopic papillary balloon dilation（EPBD）,statistics of two groups in patients with the incidence of postoperative earl y complication include high blood am ylase,post-ERCP pancreatitis（PEP）,bleeding,perforatio n,acute cholangitis,and the success rate for removed stones,postoperative 1 year total incidence of choledocholithiasis recurrence rate,total complication rate 、 hospital stays and service condition of lithotripter during the surgery procedure,and anal ysis comparison.ResultsThere was no obvious discrepancy in gender,age,the maxium diameter of stone,number of stones,relevant disease history between the two groups,but postoperative situation were not exactl y the same.The incidence of postoperative hemorrhage of gastrointestinal tract in s EST+EPBD group（13.4%）exceeded that in EPBD group（3.2%）,and the difference was statistically significant.The incidence rate of h yperamylasemia attained 19.7% in the EPBD group,which was exceeded that of the s EST+EPBD（7.5%）.There was statistic difference between them,but there was no significant diff erence in the occurrence of PEP between the two groups（P>0.05）.There was no intraoperative or postoperative digestive tract perforation in 2 groups.Furthermore,there were no visible difference between the two groups in the success rate of stone removal,usage rate of lithotriptor,incidence of postoperative infection of biliary tract,recurrence of choledocholithiasis in postoperative 1 year,total complications rate and hospital stays（P>0.05）.Conclusion1.For the patients aged ≥ 60 years old with CBDS,compared to s EST+EPBD,using EPBD individuall y will not cause significant increase in PEP.2.In the therapy of the 60 year-old CBDS patients,EPBD and s EST+EPBD have good consistency in effective rate and incidence of postoperativ e complications.Furthermore,EPBD can decrease the genesis of postoperative bleeding,which is secure and credible and worth y of clinical application.