The Study Of Therapeutic ERCP In Elderly Patients With Biliary And Pancreatic Diseases

Objective:To identify the safety and efficacy of therapeutic ERCP in the elderly patients with biliary and pancreatic diseases,and to assess the improvement of quality of life in patients 2 weeks after surgery and 1 month after surgery.Methods:The medical records of patients with biliary and pancreatic diseases who underwent therapeutic ERCP from October 2016 to December 2018 in General Surgery of Chengde Central Hospital were collected,Patients were divided into groups A and B according to age(The United Nations World Health Organization defines older people was over the age of 75),and those aged less than 75 years old were A Group(young group),patients aged 75 years or older were in group B(elderly group).And The operation time,stone removal,stent implantation,average hospitalization days,and postoperative complications(acute pancreatitis,bleeding,perforation,acute cholangitis)were compared between the two groups,to determine the safety and efficacy of therapeutic ERCP in elderly patients with biliary and pancreatic diseases;by using the GIQLI scale questionnaire to calculate the two groups of patients before surgery,2 weeks after surgery and after surgery One-month GIQLI scale scores.The quality of life improvement was compared and evaluated 2 weeks after surgery and 1 month after surgery.Results:A total of 203 patients were enrolled in the two groups,including 105 patients in group A and 98 patients in group B.Three patients in group A were lost to follow-up at 2 weeks postoperatively,A total of 102 patients were followed up,Five patients in group B were lost to follow-up and 93 patients were followed up.Four patients in group A were lost to follow-up at 1 month postoperatively.A total of 98 patients were followed up.Three patients in group B were lost to follow-up and 90 patients were followed up.There were no significant differences in the operation time,stone removal,average hospitalization days,and postoperative complications between the two groups(P>0.05).There was a statistically significant difference in stent implantation between the two groups(P<0.05);Compared with preoperative quality of life,the two groups had statistically significant differences in the symptoms of symptoms,physiological function,mental state,social activity status and total score at 2 weeks after surgery and 1 month after surgery(P <0.05);The symptoms of Patients in group B at preoperative and postoperative 2 weeks and the physiological function status,social activity status and total score at each time point(preoperative,2 weeks after surgery,1 month after surgery)There was a difference between the two groups(P<0.05),but the symptoms at 1 month postoperatively and psychological at various time points(preoperative,2 weeks postoperative,1 month postoperative)There was no difference(P>0.05).Comparison of postoperative quality of life improvement values between groups A and B at 2 weeks postoperatively,Patients in group B had statistically significant differences in symptoms and physiological function compared with group A(P<0.05),but there was no difference in mental state,social activity status and total score(P>0.05);Comparison of postoperative quality of life improvement between group A and group B at 1 month after operation,Patients in group B had statistically significant differences in physiological function status,social activity status,and total scores compared with group A(P<0.05),There was no significant difference in the symptoms and psychological status(P>0.05).Conclusion:1.The treatment of ERCP in elderly patients with biliary and pancreatic diseases is also safe and effective;2.After treatment of ERCP in patients with biliary and pancreatic diseases,the quality of life in the early postoperative period can be improved compared with preoperative,and the quality of life of older patients is more obvious.