Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2017; 23(13): 2424-2434
Published online Apr 7, 2017. doi: 10.3748/wjg.v23.i13.2424
Therapeutic experience of 289 elderly patients with biliary diseases
Zong-Ming Zhang, Zhuo Liu, Li-Min Liu, Chong Zhang, Hong-Wei Yu, Bai-Jiang Wan, Hai Deng, Ming-Wen Zhu, Zi-Xu Liu, Wen-Ping Wei, Meng-Meng Song, Yue Zhao
Zong-Ming Zhang, Zhuo Liu, Li-Min Liu, Chong Zhang, Hong-Wei Yu, Bai-Jiang Wan, Hai Deng, Ming-Wen Zhu, Zi-Xu Liu, Wen-Ping Wei, Meng-Meng Song, Yue Zhao, Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing 100073, China
Author contributions: Zhang ZM, Liu Z, Liu LM, Zhang C, Yu HW, Wan BJ, Deng H, Zhu MW, Liu ZX, Wei WP, Song MM and Zhao Y performed the study; Liu Z collected and analyzed the data; and Zhang ZM provided the funding, designed the study and wrote the manuscript.
Supported by the Science and Technology Project of State Grid Corporation of China, No. SGHB0000AJJS1400182.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing, China.
Clinical trial registration statement: The clinical trial is registered with the Research Registry under the Research Registry Unique Identifying Number: researchregistry 2032. Details can be found at http://www.researchregistry.com /browse-the-registry.html#user-researchregistry/?view_26_search=researchregistry2032&view_26_page=1.
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Zong-Ming Zhang, MD, PhD, Professor, Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, No. A1, Taipingqiaoxili, Fengtai District, Beijing 100073, China. zhangzongming@mail.tsinghua.edu.cn
Telephone: +86-10-63503046 Fax: +86-10-63465865
Received: November 13, 2016
Peer-review started: November 13, 2016
First decision: December 29, 2016
Revised: January 14, 2017
Accepted: February 17, 2017
Article in press: February 17, 2017
Published online: April 7, 2017
Processing time: 144 Days and 8.7 Hours
Abstract
AIM

To present clinical characteristics, diagnosis and treatment strategies in elderly patients with biliary diseases.

METHODS

A total of 289 elderly patients with biliary diseases were enrolled in this study. The clinical data relating to these patients were collected in our hospital from June 2013 to May 2016. Patient age, disease type, coexisting diseases, laboratory examinations, surgical methods, postoperative complications and therapeutic outcomes were analyzed.

RESULTS

The average age of the 289 patients with biliary diseases was 73.9 ± 8.5 years (range, 60-102 years). One hundred and thirty-one patients (45.3%) had one of 10 different biliary diseases, such as gallbladder stones, common bile duct stones, and cholangiocarcinoma. The remaining patients (54.7%) had two types of biliary diseases. One hundred and seventy-nine patients underwent 9 different surgical treatments, including pancreaticoduodenectomy, radical resection of hilar cholangiocarcinoma and laparoscopic cholecystectomy. Ten postoperative complications occurred with an incidence of 39.3% (68/173), and hypopotassemia showed the highest incidence (33.8%, 23/68). One hundred and sixteen patients underwent non-surgical treatments, including anti-infection, symptomatic and supportive treatments. The cure rate was 97.1% (168/173) in the surgical group and 87.1% (101/116) in the non-surgical group. The difference between these two groups was statistically significant (χ2 = 17.227, P < 0.05).

CONCLUSION

Active treatment of coexisting diseases, management of indications and surgical opportunities, appropriate selection of surgical procedures, improvements in perioperative therapy, and timely management of postoperative complications are key factors in enhancing therapeutic efficacy in elderly patients with biliary diseases.

Keywords: Biliary diseases; Elderly patients; Surgical treatment; Non-operative treatment

Core tip: With global prolongation of life expectancy, biliary diseases in elderly patients appear to be common and multifaceted. The purpose of this study was to determine the clinical characteristics and treatment strategies in elderly patients with biliary diseases in order to improve diagnosis and treatment. Active treatment of coexisting diseases, management of indications and surgical opportunities, appropriate selection of surgical procedures, improvements in perioperative therapy, and timely management of postoperative complications are key factors in enhancing therapeutic efficacy in elderly patients with biliary diseases.