Mika Ukkonen1, Antti Siiki1, Anne Antila1, Tuula Tyrväinen1, Juhani Sand1, Johanna Laukkarinen2. 1. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland. 2. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland. johanna.laukkarinen@fimnet.fi.
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.
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.
Authors: Arthur John Kaffes; Luke Hourigan; Nicolas De Luca; Karen Byth; Stephen John Williams; Michael John Bourke Journal: Gastrointest Endosc Date: 2005-02 Impact factor: 9.427
Authors: M L Freeman; J A DiSario; D B Nelson; M B Fennerty; J G Lee; D J Bjorkman; C S Overby; J Aas; M E Ryan; G S Bochna; M J Shaw; H W Snady; R V Erickson; J P Moore; J P Roel Journal: Gastrointest Endosc Date: 2001-10 Impact factor: 9.427
Authors: Daisy Walter; Petra G A van Boeckel; Marcel J Groenen; Bas L A M Weusten; Ben J Witteman; Gi Tan; Menno A Brink; Jan Nicolai; Adriaan C Tan; Joyce Alderliesten; Niels G Venneman; Wim Laleman; Jeroen M Jansen; Alexander Bodelier; Frank L Wolters; Laurens A van der Waaij; Ronald Breumelhof; Frank T M Peters; Robbert C H Scheffer; Max Leenders; Meike M C Hirdes; Ewout W Steyerberg; Frank P Vleggaar; Peter D Siersema Journal: Gastroenterology Date: 2015-03-17 Impact factor: 22.682
Authors: Francisco Javier Rodríguez-González; Antonio Naranjo-Rodríguez; Inmaculada Mata-Tapia; Mayte Chicano-Gallardo; Juan Jesús Puente-Gutierrez; Patricia López-Vallejos; Antonio José Hervás-Molina; Juan Francisco de Dios-Vega Journal: Gastrointest Endosc Date: 2003-08 Impact factor: 9.427
Authors: E J Williams; S Taylor; P Fairclough; A Hamlyn; R F Logan; D Martin; S A Riley; P Veitch; M L Wilkinson; P R Williamson; M Lombard Journal: Endoscopy Date: 2007-09 Impact factor: 10.093
Authors: Luciano Hybner; Fernando Issamu Tabushi; Luis Martins Collaço; Érika Gomes DA Rosa; Bruno de Faria Melquíades DA Rocha; Mateus Franzoni Bochnia Journal: Arq Bras Cir Dig Date: 2022-01-05
Authors: Marianna Galeazzi; Paolo Mazzola; Breanna Valcarcel; Giuseppe Bellelli; Marco Dinelli; Giulio Maria Pasinetti; Giorgio Annoni Journal: BMC Gastroenterol Date: 2018-03-14 Impact factor: 3.067