Endoscopic retrograde cholangiopancreatography in the elderly: results of a retrospective study and a geriatricians’ point of view

BMC Gastroenterology

Breanna Valcarcel¹  Giulio Maria Pasinetti¹  Marco Dinelli²  Giorgio Annoni³  Marianna Galeazzi³  Paolo Mazzola³  Giuseppe Bellelli³ 

[1] Icahn School of Medicine at Mount Sinai;San Gerardo Hospital ASST Monza, Endoscopy Unit;University of Milano-Bicocca, School of Medicine and Surgery;

关键词: Endoscopic retrograde cholangiopancreatography;    ERCP;    Endoscopy;    Elderly;    Procedural complications;   

DOI  :  10.1186/s12876-018-0764-4

来源: DOAJ

【 摘 要 】

Abstract Background The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated. Methods We retrospectively analyzed the clinical records of all patients aged ≥65 undergoing ERCP between July 2013 and July 2015. Of 387 ERCP cases, 363 (~ 94%) were completed entirely. The mean age of the study population (n = 363) was 79.9 years old (range 70–95), with 190 subjects aged 70–79 and 173 older than 80. We recorded demographics, Charlson Comorbidity index (CCI), American Society of Anesthesiologists (ASA) physical status classification score, indication for the use of the ERCP procedure, and clinical outcomes. Then, we tested all variables to identify the potential risk factors for complications associated with the procedure. Results The older group (those ≥80 years old) showed significantly more patients with ASA Classes III-IV than the younger one (those ≤79 years old). Interestingly, the CCI was higher in the younger group (p = 0.009). The overall complication rate was 17.3% without inter-group differences. Older age, sex, CCI and intra-ERCP procedures were not related to a higher risk of complications, and the multivariate regression did not identify any of the considered variables to be an independent risk factor for complications. Conclusion ERCP appears as safe in the patients aged 80 years and older, as it is in those aged 70–79 years old in our study, however, a selection bias may affect these findings. A study including a comprehensive geriatric assessment will contribute to shedding light on this issue.

【 授权许可】

Unknown