L'uso delle endoprotesi chirurgiche nel trattamento della litiasi della VBP nell'anziano.

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 - oldest patients with thinner hypovascularized ectasic choledochal wall - permanent transpapillary polyurethane prostheses 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 epatocholedochal lumen with the aim of avoiding collapse.