Effect analysis of ursodeoxycholic acid combined with endoscopic retrograde cholangiopancreatography in the treatment of complex cholangiolithiasis in elderly patients
Effect analysis of ursodeoxycholic acid combined with endoscopic retrograde cholangiopancreatography in the treatment of complex cholangiolithiasis in elderly patients
AIM To analyze the effect of ursodeoxycholic acid(UDCA)combined with endoscopic retrograde cholangiopancreatography(ERCP)in treating complex cholangiolithiasis in elderly patients,and to provide reference for clinical treatment.METHODS A total of 64 elderly patients with complex cholangiolithiasis admitted to the hospital from January 2020 to April 2023 were prospectively selected and randomly divided into observation group(32 patients)and control group(32 patients).The control group was given conventional ERCP and biliary stent placement,and gallstones were also removed.The observation group was given UDCA treatment for 2 months in addition to the treatment of the control group.The second ERCP was performed between 3 and 6 months after the first ERCP,during which the stent was removed and gallstones were retaken.The maximums stone diameter and the number of stones removed during the first ERCP procedure,as well as the maximum stone diameter,the number of stones removed,the success rate,and the stone extraction time during the second ERCP procedure were all recorded.Levels of liver function indicators[alkaline phosphatase(AKP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transpeptidase(GGT),total bilirubin(TBIL),direct bilirubin(DBIL),total bile acids(TBA),and conjugated bilirubin(CB)]were compared between 2 groups before treatment and after twice ERCP procedures.Additionally,the improvement in symptoms,gastrointestinal quality of life index(GIQLI)scores,and the incidence of complications after twice ERCP procedure were assessed and compared between 2 groups.RESULTS There were no significant differences in the maximum stone diameter and number of stones between 2 groups(P＞0.05).The maximum stone diameter and the number of stones in the observation group were smaller than those in the control group at the second time of ERCP extraction,the success rate of stone extraction was higher than that in the control group,and the time of stone extraction was shorter than that in the control group,with significant differences(P＜0.05).The disappearance rates of biliary colic,fever,abdominal distension and abdominal pain in the observation group were better than those in the control group(P＜0.05).After the first ERCP,the liver function indexes of 2 groups were lower than those before treatment(P＜0.01).After the second ERCP,the liver function indexes of 2 groups were lower than those before treatment and after the first ERCP(P＜0.01),and the observation group was significantly lower than the control group(P＜0.01).The GIQLI scores of 2 groups after the second ERCP were higher than those before treatment and after the first ERCP(P＜0.01),and the GIQLI score of the observation group was higher than that of the control group(P＜0.01).The GIQLI score of the observation group was higher than that of the control group after the second ERCP removal(P＜0.05).There was no significant difference in the total incidence of complications between 2 groups(P＞0.05).CONCLUSION The UDCA combined with ERCP can enhance the therapeutic outcomes for elderly patients with complex cholangiolithiasis,alleviate clinical symptoms,improve liver function and quality of life,and favorably impact the success rate of subsequent stone extraction.It also demonstrates good safety,making it worthy of clinical promotion.
维普
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