Urgent endoscopic papilosphincterotomy in individuals older than 70 years

Česká verzia

Authors: Petr Dítě ¹ ; Z. Papík ²; M. Kunovská ¹; I. Novotný ¹; Bohuslav Kianička ³ ; P. Piskač ⁴; V. Zbořil ¹; M. Zavoral ⁵
Authors place of work: Interní gastroenterologická klinika FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Dítě, DrSc. ¹; II. interní klinika Lékařské fakulty UK a FN, Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc. ²; Gastroenterologické oddělení FN u sv. Anny, Brno, přednosta prim. MUDr. Vladimír Bednařík ³; II. chirurgická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Jindřich Leypold, CSc. ⁴; II. interní oddělení, Klinika gastroenterologie a hepatologie 1. lékařské fakulty UK a ÚVN, Praha, přednosta doc. MUDr. Miroslav Zavoral, Ph. D. ⁵
Published in the journal: Vnitř Lék 2005; 51(5): 529-532
Category: Original Contributions

Summary

Therapeutic endoscopy of acute pancreatobiliary conditions is represented in absolute majority of cases by endoscopic papilosphincterotomy performed after verification of finding in biliary duct and pancreatic duct by means of endoscopic retrograde cholangiopancreatography. Endoscopic operation is, of course, invasive performance that burdens the patients; therefore it is also accompanied with possible complications. In elderly individuals a risk factor of performance is undoubtedly polymorbidity, especially cardiovascular and bronchopulmonary diseases. In prospective study with individuals older than 70 years with acute cholangitis and acute biliary pancreatitis we evaluated performance safety and its effectivity as regards to the influence on the course of disease. We demonstrated that endoscopic papilosphincterotomy in mentioned conditions is safe performance, significantly favourably inflicting further development of the disease even in elderly patients. Nevertheless it is accepted that this performance in risk groups of individuals should be performed in the site, where the doctor-endoscopist has enough experience and the site is provided with the intensive medical care facility.

Key words:
pancreatitis – cholangitis – endoscopic papilotomy – elderly population

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