Endoscopic placement of biliary stents for treatment of high risk geriatric patients with common duct stones.
Ten elderly (mean age, 77 yr) sick patients with large common duct stones were managed with stents when conventional nonsurgical methods for stone extraction failed. Five subjects had intact gallbladders, and four of these had cholelithiasis. Patients were at increased risk for perioperative complications--yet endoscopic placement of stents was performed safely in all instances. Pain and jaundice resolved and elevated serum bilirubin values returned to normal in all patients. After a maximum follow up of 35 months, no subject has required surgery for biliary symptoms or complications. Two patients have died, one following elective cholecystectomy and common duct exploration and another from unrelated causes. These results suggest that endoscopic placement of stents for management of large common duct stones is safe, and favorable long-term results can be achieved. Geriatric patients who are unfit for surgery are probably good candidates for this treatment.
Foutch
P G
PG
Division of Gastroenterology, Carl T. Hayden VA Medical Center, Phoenix, Arizona.
Harlan
J
J
Sanowski
R A
RA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts; D002408:Catheters, Indwelling; D004724:Endoscopy; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged