[The use of surgical endo-prosthesis in the treatment of choledocolithiasis in the elderly. Personal experience].
BACKGROUND
The usefulness of biliary endoprostheses in some selected elderly patients affected by hepato-choledocolithiasis is described.


METHODS
In the Department of Surgery, University of Perugia, 119 elderly patients were surgically treated for choledocholithiasis from January 1999 to December 2000. In 44 selected cases#151;oldest patients with thinner hypovascularized ectasic choledochal wall#151; a permanent transpapillary polyurethane prosthesis was placed, after choledocolithotomy with or without sphinterotomy; sometimes prosthesis was placed under the duodenal mucosa.


RESULTS
Endoprosthesis had a long duration and gave good results in canalization and periprosthetic flow, in absence of biliary stasis and/or angiocholitis. Only one patient had prostheses displacement.


CONCLUSIONS
On the basis of personal experience and considering physiopathology and pathogenesis of biliary stones in the elderly, the authors underline, in selected cases, the need of stenting the hepatocholedochal lumen with the aim of avoiding collapse.
Burattini
M F
MF
Policlinico Monteluce, Dipartimento di Scienze Chirurgiche, Sezione di Chirurgia Generale e Oncologica, Università degli Studi di Perugia, Perugia, Italy. bsensi@unipg.it
Covarelli
P
P
Cristofani
R
R
Moriconi
E
E
Servoli
A
A
Cavazzoni
E
E
Ricci
E
E
Bartoli
A
A
D000368:Aged; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003135:Common Bile Duct / Q000473:pathology / Q000601:surgery; D005260:Female; D042882:Gallstones / Q000188:drug therapy / Q000601:surgery*; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid