Early endoscopic therapy for elderly patients with acute severe biliary pancreatitis

Abstract

Objective To evaluate the clinical effects of early endoscopic therapy for elderly pa- tients with acute severe biliary pancreatitis. Methods Ninety-two elderly patients with acute severe biliary pancreatitis were randomly divided into 2 groups ： ERCP group （ n = 43 ） and non-ERCP group （ n = 49）. Se- rum TNF-α, IL-6, IL-8, the recovery time of blood amylase, the duration of abdominal pain, hospitaliza- tion, mortality and complications were compared. Results ERCP group showed a greater decrease in serum TNF-α, IL-6 and IL-8 levels than the control group （ 45.16 ± 13.48 ） Ixg/L v. s. （ 176. 89 ± 47.35 ） μg/L, （31.76±13.85）μg/Lvs. （68.48 ±24.87）μg/L, （113.39± 63. 78 ） μg/L v.s. （309.86±117.13） μg/L） （P 〈0. 05 ）. The duration of abdominal pain, the recovery time of blood amylase and hospitalization in ERCP group were significantly shorter compared to the non-ERCP group [ （ 10. 2 ±1.7） d v.s. （ 13.2± 2.4）d, （3.3±1.0）dv.s. （5.5±1.2）d, （15±1.6）dv.s. （20 ±3.0）d] （P〈0.05）,andcomplication rate of the ERCP group was lower, too （5% v.s. 22% , P 〈 0. 05 ）. Conclusion Early ERCP is safe and highly effective for the elderly patients with acute severe biliary pancreatitis. Key words: Aged ; Pancreatitis ; Acute disease ; Cholangiopancreatography, endoscopic retro- grade ; Tumor necrosis factor-alpha; Interleukins