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 ≥80years of age. METHODS: Patients 80years of age or older (n=312) and younger than 65years (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 ≥80years and those <65years of age, although the elderly group had a higher rate of comorbid diseases and used anti-thrombotic drugs more frequently.