Clinical value of encoscopic retrograde cholangio-pancreatography combined with percutaneous transhepatic cholangial drainage in the treatment of elderly patients with cholangitis caused by com-mon bile duct stones
Objective Exploring the clinical efficacy of Endoscopic Retrograde Cholangiopancre-atography combined with Percutaneous Transhepatic Cholangioplasty and Drainage in the treatment of elder-ly patients with cholangitis caused by common bile duct stones.Methods The study observed 60 elderly patients with cholangitis caused by common bile duct stones,who were admitted between January 2023 and January 2024.By using a random number table method,30 patients in the control group received PTCD treatment,while 30 patients in the observation group received PTCD combined with ERCP treatment.com-pare the changes in quality of life,liver and gallbladder biochemical indicators,and inflammatory indica-tors between two groups of patients,and also compare the time for clinical symptom relief between the two groups.Results The total score of the digestive system disease quality of life index(GLQI)in the postop-erative observation group was higher than that in the control group[(127.03±6.52)points compared to(105.81±5.46)points],and the difference was statistically significant(t=13.667,P<0.05);The ser-um total bilirubin(TBiL),direct bilirubin(DBil),alanine aminotransferase(ALT),and aspartate amin-otransferase(AST)in the postoperative observation group were all lower than those in the control group[(34.98±3.75)μ mol/L,(24.69±3.81)μ mol/L,(64.79±5.86)U/L,(61.09±4.36)U/L vs.(58.42±7.62)μ mol/L,(37.12±4.54)μ mol/L,(77.13±9.32)U/L,(90.12±7.71)U/L],and the differences were statistically significant(t=15.117,11.487,6.139,17.952,P<0.05);The white blood cell count(WBC),C-reactive protein(CRP),and procalcitonin(PCT)levels in the observation group were lower than those in the control group[(13.08±1.09)×109/L,(1.49±0.38)mg/L,(29.54±2.71)μg/L vs.(15.73±1.16)×109/L,(2.08±0.51)mg/L,(36.48±3.38)μg/L],and the differences were statistically significant(t=9.119,5.081,8.774,P<0.05);The relief time of abdominal pain,fever,and jaundice in the observation group were shorter than those in the control group[(4.43±0.52),(1.99±0.32),(2.43±0.46)d vs.(5.89±0.97),(2.87±0.46),(3.15±0.61)d],and the difference was statistically significant(t=7.266,8.602,5.162,P<0.05).Conclusion The use of ERCP combined with PTCD for the treatment of cholangitis caused by common bile duct stones in elderly patients is a statistical difference in the effect,and the effect is effective and has practical value.
Encoscopic retrograde cholangio-pancreatographyPercutaneous transhepatic cholangial drainageAdvanced ageCommon bile duct stonesCholangitis