ERCP in patients 90 years of age and older.
BACKGROUND
Biliary diseases represent particular diagnostic and therapeutic problems in elderly patients.


METHODS
Patients 90 years of age or older who underwent ERCP from January 1993 to September 2001 were studied retrospectively.


RESULTS
A total of 126 patients underwent 147 ERCP procedures (range 1-5 per patient). Twelve additional ERCPs were performed in 9 of the patients during follow-up because of recurrent symptoms. A total of 159 procedures were, therefore, available for analysis. The most frequent indications were suspicion of bile duct stones (46.8%) and obstructive jaundice (35.7%). Midazolam (95.6%) was used for conscious sedation and hyoscine (74.8%) for duodenal ileus. Patient tolerance of the procedure was good in 92.4% of sessions. Diagnoses included bile duct stones (54%), bile duct dilatation without any apparent obstruction (11.9%), and malignant stenosis (9.5%). Therapeutic procedures were indicated in 95.6% of diagnosed patients and completed in 96.3% of cases. Complications occurred in association with 2.5% of the ERCP procedures; the procedure-related mortality rate was 0.7%.


CONCLUSIONS
ERCP in elderly patients is practicable. The complication rate is low, and therapeutic efficacy is good.
Rodríguez-González
Francisco Javier
FJ
Gastroenterology Department, Hospital Reina Sofía, Córdoba, Spain.
Naranjo-Rodríguez
Antonio
A
Mata-Tapia
Inmaculada
I
Chicano-Gallardo
Mayte
M
Puente-Gutierrez
Juan Jesús
JJ
López-Vallejos
Patricia
P
Hervás-Molina
Antonio José
AJ
de Dios-Vega
Juan Francisco
JF
D000759:Adjuvants, Anesthesia; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous; D001661:Biliary Tract Neoplasms / Q000150:complications; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D016292:Procedural Sedation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008874:Midazolam; D012189:Retrospective Studies; D012601:Scopolamine; D016717:Sphincterotomy, Endoscopic; D015607:Stents
D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D012601:Scopolamine; D008874:Midazolam