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Journal List > Korean J Gastroenterol > v.58(2) > 1006908

Cho, Park, Oh, Chung, Yoo, Kim, and Shim: A Single Institution's Experience of Endoscopic Retrograde Cholangiopancreaticography in the Eldery Patients: Outcomes, Safety and Complications

Abstract

Background/Aims

As the population ages, endoscopic retrograde cholangiopancreaticography (ERCP) is being used increasingly as a diagnostic and therapeutic tool for elderly patients with pancreatobiliary disease. The aim of this study was to assess the outcomes, safety and complications associated with ERCP performed in the elderly patients.

Methods

We retrospectively reviewed the medical record of 596 patients who were 50 years of age or older and underwent ERCP from January 2005 to September 2010. The patients were classified into two groups according to the age: non-elderly, 50–74 years old and elderly, ≥75 years old. Comparisons were made between two groups.

Results

Five hundred and ninety-six patients (132 elderly and 464 non-elderly patients) were enrolled. The success rate of ERCP was 89.4% in the elderly and 91.9% in the non-elderly. The major complications were occurred in 11 patients of the elderly and 16 of the non-elderly, and the complication rate was significantly higher in the elderly compared to the non-elderly (8.3% vs. 3.4%, p=0.011). Pancreatitis occurred in 2 elderly patients and 10 non-elderly patients (1.5% vs. 2.1%, p=1.0). There was a higher rate of bleeding in the elderly patients (4.5% vs. 1.3%, p=0.01).

Conclusions

ERCP is effective and safe even in elderly patients. Outcomes of diagnostic and therapeutic ERCP in the elderly patients were similar to those in non-elderly patients. Elderly patients undergoing ERCP carried similar risk of pancreatitis but a higher risk of bleeding and perforation compared to non-elderly patients.

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Table 1.
Baseline Characteristics of Patients
  Elderly (≥75 year)(n=132) Non-elderly (50–74 year)(n=464)
Mean age, yr (range) 79.3 (75–93) 63.4 (50–74)
Male:Female 54:78 293:171
Indication of ERCP, n (%)    
 GB stone 2 28
 CBD stone 94 (71.2) 310 (66.8)
 Cholangitis 9 40
 Pancreatitis 8 30
 Obstructive jaundice 7 16
 Others 12 (9.1) 40 (8.6)
Type of procedures, n (%)    
 Diagnostic ERCP 27 (25.7) 63 (13.5)
 Therapeutic ERCP 105 (74.3) 401 (86.5)
Mean procedure time, min 22.78 25.22
Comorbidities, n (%) 62 (46.9) 174 (37.5)
 Diabetes 18 63
 Cardiovascular diseases 41 83
 Pulmonary diseases 8 9
 Hepatic diseases 4 22
 Renal diseases 1 5
 Cerebrovascular diseases s 8 12
 Malignancies 6 15
 Others 7 33

GB, gallbladder; CBD, common bile duct.

Table 2.
Success Rate of ERCP in Elderly and Non-elderly Patients
  Elderly (≥75 year) (n=132) Non-elderly (50–74 year) (n=464) p-value
Success, n (%) 118 (89.4) 425 (91.9) 0.389
Failure, n (%) 14 (10.6) 38 (8.1)  
 Periampullary diverticulum 2 1  
 Cannulation failure 10 34  
 Poor cooperation 2 3  
Table 3.
Complications of ERCP in Elderly and Non-elderly Patients
  Elderly (≥75 year) (n=132) Non-elderly (50–74 year) (n=464) p-value
Complications, n (%) 11 (8.3) 16 (3.4) 0.011
 Pancreatitis 2 10 1
 Bleeding 6 (4.5) 6 (1.3) 0.01
 Perforation 3 0 0.011
 Death 0 1 1
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