Endoscopic therapy for bile duct stones in a geriatric population

During the 5 year period to May 1988, 137 consecutive patients (age range, 65-102 years; median 84 years) with a diagnosis of choledocholithiasis, were referred to The Middlesex Hospital Geriatric Department. Endoscopic sphincterotomy was successful in 96.2% of cases and immediate biliary drainage w...

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Bibliographic Details
Published in:Postgraduate medical journal 1992-06, Vol.68 (800), p.457-460
Main Authors: Croker, J. R., Williams, S. G., Charlton, M., Vaira, D., Dowsett, J.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Cholangiopancreatography, Endoscopic Retrograde
Diseases of the digestive system
Female
Follow-Up Studies
Gallstones - surgery
Humans
Male
Medical sciences
Postoperative Complications - mortality
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Reoperation
Sphincterotomy, Endoscopic
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Summary:During the 5 year period to May 1988, 137 consecutive patients (age range, 65-102 years; median 84 years) with a diagnosis of choledocholithiasis, were referred to The Middlesex Hospital Geriatric Department. Endoscopic sphincterotomy was successful in 96.2% of cases and immediate biliary drainage was achieved in all but one of these patients. Stones were cleared endoscopically in 73.3% and surgically in 4.7% of cases. Long-term stenting was employed in 14.3% of patients. The 30 day mortality after endoscopic or surgical treatment was 4.7% (six deaths), although death was probably unrelated to therapy in half the cases. Deaths were due to procedural cardiorespiratory arrest (1), pancreatitis (1), pneumonia (2) and cerebrovascular accident (2). Endoscopic treatment is effective even in a high-risk geriatric population. After sphincterotomy patients with intact gall bladders should be managed expectantly.
ISSN:0032-5473
1469-0756
DOI:10.1136/pgmj.68.800.457