Efficacy and long-term outcomes of regular replacement of stent and long-term biliary stenting in the treatment of common bile duct stones in elderly patients over 85 years old

Abstract

Of 310 patients over 85 years old with common bile duct stone, 130 patients with poor general condition, refractory common bile duct stones underwent endoscopic biliary stenting, and the long-term outcomes of 62 patients who underwent regular replacement of stent and 68 patients who underwent long-term biliary stenting were reviewed. In the regular replacement of stent group, 14 patients had stone reduction and complete stone removal after replacement of stent. 27 patients died of other causes. Stent-stone complex was observed in 2 cases. In the long-term biliary stenting group, 9 patients died of other causes, but the long-term follow-up of 59 patients was difficult. Since death from other causes may determine the prognosis in the elderly, treatment strategies based on ECOG performance status and Charlson comorbidity index are necessary in cases of symptomatic and refractory common bile duct stones. The treatment options for each case should be complete stone removal, regular replacement of stent, or long-term biliary stenting.