Efficacy and Safety of Therapeutic Endoscopic Retrograde Cholangiopancreatography in the Elderly Over 80 Years

Abstract

Background/Aims

Concern regarding the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients is increasing as a result of the aging society. However, there are limited data, especially in the super-aged elderly. This study aimed to evaluate the efficacy and safety of therapeutic ERCP in patients ≥80 years of age.

Methods

Patients 80 years of age or older (n = 312) and younger than 65 years (n = 312) who underwent therapeutic ERCP from June 2006 to April 2014 were randomly selected and analyzed retrospectively. The main outcome measurements were therapeutic ERCP-related complications and clinical outcomes in the two groups.

Results

Choledocholithiasis combined with gallbladder stone was the most common indication for ERCP in both groups. Comorbid diseases (70.5 and 29.8 %, p < 0.001) and the use of anti-thrombotic drugs (18.6 and 1.6 %, p < 0.001) were more frequent in the super-aged group. The mean procedure time was longer, and the frequency of second ERCP was more common in the super-aged group. However, the technical success rate (94.9 and 97.4 %, p = 0.096) and the procedure-related complication rate (4.8 and 5.8 %, p = 0.592) were not different between the two groups. Post-ERCP pancreatitis occurred in 1.3 % of the super-aged group and in 2.9 % of the control group (p = 0.262). Cardiopulmonary complications occurred in 1.9 % of patients in each group (p = 1.0).

Conclusions

Therapeutic ERCP is comparable in terms of efficacy and safety between patients ≥80 years and those <65 years of age, although the elderly group had a higher rate of comorbid diseases and used anti-thrombotic drugs more frequently.

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