Effects of SEST combined with balloon dilation lithotomy on stone removal and quality of life in elderly patients with complex choledocholithiasis
Objective To explore the effects of small endoscopic sphincterotomy(SEST)combined with balloon dila-tation lithotomy on complex choledocholithiasis in elderly patients and its influence on lithotomy time and incidence of acute pancreatitis.Methods 105 elderly patients with complex choledocholithiasis undergoing surgical treatment in Jiaozhou Central Hospital from June 2020 to December 2022 were selected.Among them,54 ones receiving SEST combined with balloon dilata-tion lithotomy were assigned to observation group,and 51 ones receiving SEST combined with conventional stone basket lithot-omy were assigned to control group.The surgical time,lithotomy conditions and recovery conditions were compared between the two groups.The incidence of complications such as perforation,delayed bleeding,acute pancreatitis,hyperamylasemia,biliary tract infection within 3 days after surgery were recorded and compared between the two groups.The stress response(cortisol,epinephrine)and risk score of disease recurrence within 24 hours after surgery were compared between the two groups.The changes in score of Gastrointestinal Quality of Life Index(GIQLI)were compared between the two groups before treatment and after 14 days of treatment.Results There was no statistical significance in surgical time between groups(P＞0.05).Compared with the control group,the lithotomy time in the observation group was shorter,the success rate of one-time lithotomy was higher,and the mechanical lithotripsy rate was lower(P＜0.05).There was no statistical difference in the pro-portion of patients with general anesthesia between the two groups(P＞0.05),but the postoperative ambulation time of general anesthesia patients and hospital stay in the observation group were shorter than those in the control group(P＜0.05).There was no significant difference in hospitalization cost between the two groups(P＞0.05).Within 3 days after surgery,the inci-dence of complications in the observation group was lower than that in the control group(P＜0.05).The levels of cortisol and epinephrine and score of disease recurrence after surgery of the observation group were lower than those of the control group(P＜0.05).After 14 days of treatment,the GIQLI scores of both groups were higher than those of the same group before treatment,and the scores of the observation group were higher than those of the control group(P＜0.05).Conclusion For elderly patients with complex choledocholithiasis,SEST combined with balloon dilatation lithotomy has high lithotomy efficien-cy.It can significantly reduce the incidence of complications after surgery and effectively improve the quality of life of patients,and has clinical application value.
elderlycholedocholithiasissmall endoscopic sphincterotomyballoon dilatation lithotomylithotomy time
国家科技期刊平台
NSTL
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