Safety and Efficacy of Acute Endoscopic Retrograde Cholangiopancreatography in the Elderly.
Dig Dis Sci
; 61(11): 3302-3308, 2016 11.
Article
en En
| MEDLINE
| ID: mdl-27565508
ABSTRACT
BACKGROUND:
Endoscopic retrograde cholangiopancreatography (ERCP) is a frequent procedure in elderly patients.AIMS:
We aimed to determine the safety and efficacy of acute ERCP in older patients.METHODS:
A prospectively managed, hospital-based registry containing all ERCP procedures and complications at a tertiary referral center was used to form the study population, which consisted of consecutive elderly (≥65 years) patients undergoing acute ERCP during the 5-year study period. Indications, details, outcome, and complications of the procedure were analyzed in relation to patient age, gender, and co-morbidities.RESULTS:
A total of 480 elderly patients (median age 78; range 65-97; 48 % men) underwent 531 ERCPs during the study period. The most common indications were bile duct stones (56.1 %) and biliary obstruction caused by malignancy (33.7 %). Successful stone extraction was achieved in 72.8 %, and with an additional, planned ERCP in 96.6 % of the patients. Post-ERCP complications developed in 3.4 % of the patients. These included pancreatitis in 1.7 %, hemorrhage in 0.6 %, and duodenal perforation in 0.2 % of the patients. One of these (0.2 %) was considered severe as this patient required invasive treatments and prolonged hospital stay. The risk of complications was associated with chronic obstructive pulmonary disease and difficult cannulation. Procedure-related mortality was zero, but overall 30-day mortality was 10 %, being 24 % in the patients with malignancy.CONCLUSIONS:
ERCP can be safely and efficaciously performed on elderly patients. The high mortality should be taken into consideration when selecting therapeutic options.Palabras clave
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Banco de datos:
MEDLINE
Asunto principal:
Pancreatitis
/
Neoplasias de los Conductos Biliares
/
Colelitiasis
/
Sistema de Registros
/
Colestasis
/
Colangiopancreatografia Retrógrada Endoscópica
/
Hemorragia Posoperatoria
/
Perforación Intestinal
Tipo de estudio:
Etiology_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Dig Dis Sci
Año:
2016
Tipo del documento:
Article
País de afiliación:
Finlandia