Endoscopic retrograde cholangiopancreatography in the elderly

Background. Endoscopic retrograde cholangiopancreatography (ERCP) is a widely used technique for the diagnosis and treatment of biliary and pancreatic diseases. Objective. To know the complication rate of ERCP in the elderly. Patients and methods. Patient files who underwent ERCP were reviewed and were divided into two groups: aged 65 and older (group 1) and less than 65 years (group 2). Socio-demographic variables, prophylactic antibiotic use, indications for ERCP and outcomes were assessed. Results. Mean age in group 1 was 72.9 years and 41.7 years in group 2. Group 1 had more comorbidity (p < 0.001). The most frequent indication for the procedure was obstructive jaundice in both groups (63% versus 44%; p = 0.002). Malignancy was more frequent as a cause of biliary obstruction in group 1 (45% versus 21%; p < 0.001). ERCP was performed once in 76% in group 1 and 93% in group 2 (p = 0.001). Prophylactic antibiotics were used more frequently in group 1 (84% versus 60%; p < 0.001). There were no differences between groups regarding infectious complications (p = 0.700). There was no difference in mortality rates between groups. Conclusion. ERCP is a safe procedure in elderly patients. The elderly frequently have more comorbidity. Nevertheless, the complication and mortality rates did not differ in this study. It is noteworthy that elderly patients received prophylactic antibiotics more frequently than younger patients but infectious complications were not different. The patients should not be excluded from ERCP based on their age.