Efficacy and Safety of Therapeutic ERCP in the Elderly: A Single Center Experience

Background:Endoscopic retrograde cholangiopancreatography (ERCP) has been an important therapeutic measure for the treatment of pancreatobiliary diseases in the elderly, but limited data on the use of ERCP in the super-aged elderly are available. This study aimed to evaluate the efficacy and safety of ERCP in patients 80 years of age or older.Methods:All therapeutic ERCPs performed from January 2012 to December 2015 at our endoscopy unit were retrospectively reviewed to evaluate the clinical outcomes and ERCP-related complications in patients 80 years of age or older (group A) and in patients younger than 65 years of age (group B).Results:A total of 141 patients (182 procedures) were 80 years of age or older (group A), and 513 patients (610 procedures) were 65 years old or younger (group B). Chronic concomitant diseases (73.05% vs. 31.19%, P<0.01) and the use of antithrombotic drugs (25.53% vs. 15.01%, P<0.01) were more frequent in group A than in group B. Common bile duct (CBD) stones were the most common indication for ERCP in both groups. The rate of a difficult cannulation was higher in group A than in group B (23.63% vs. 16.56%, P<0.01). The mean procedure time was longer, and second ERCPs were performed more frequently in group A than in group B. In addition, periampullary diverticulum was observed significantly more frequently in group A (30.22% vs. 20%, P<0.01) than in group B. The overall success rate (92.31% vs. 93.93%, P>0.05) and the complication rate (6.59% vs. 5.25%, P>0.05) were not significantly different between the 2 groups.Conclusions:ERCP is a safe and effective intervention in patients 80 years of age or older, although elderly patients had a high rate of concomitant chronic diseases and used antithrombotic drugs more frequently.