title: Efficacy and safety of therapeutic ERCP in patients 90 years of age and older.
abstract: BACKGROUND
  Therapeutic ERCP has an established role in the treatment of pancreatobiliary diseases, but little information is available on the outcomes of this procedure in patients 90 years of age and older.
  
  
  OBJECTIVE
  To evaluate the efficacy and the safety of therapeutic ERCP in an extremely elderly cohort.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Two Greek cohorts of patients > or =90 and 70 to 89 years of age who underwent therapeutic ERCPs.
  
  
  METHODS
  Sixty-three patients aged 90 years and older (group A) and 350 patients 70 to 89 years of age (group B).
  
  
  METHODS
  A retrospective review of therapeutic ERCPs was performed between 1994 and 2000 on both groups, identified by using a database linked to the endoscopy reporting system in our department.
  
  
  METHODS
  Efficacy and safety of therapeutic ERCPs. Concomitant diseases, complications, and outcome were also evaluated.
  
  
  RESULTS
  Group A patients had a higher incidence of concomitant diseases than group B patients (100% vs 72.8%, respectively). The rate of post-ERCP early complications was low in both groups: 6.3% in group A and 8.4% in group B. The frequency of ERCP-related mortality was 1.6% (1 patient) in group A and 0.6% (2 patients) in group B. Group A required endoscopic sessions for stone clearance and mechanical lithotripsy more frequently than group B (20.6% vs 11.4% and 17.5% vs 10.3%, respectively). No patient in either group experienced subjective deterioration in mental status, and the 3 patients who died required ventilatory support before death. Late complications occurred in 2.3% of patients in group B.
  
  
  CONCLUSIONS
  Therapeutic ERCP is safe and effective for the treatment of pancreatobiliary diseases in extremely elderly patients, and advanced age per se should not impinge on decisions relating to its use.
authors.affiliation: Department of Endoscopy and Motility Unit, Central Hospital, Thessaloniki, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Katsinelos
authors.forename: George
authors.initials: G
authors.lastname: Paroutoglou
authors.forename: Jannis
authors.initials: J
authors.lastname: Kountouras
authors.forename: Christos
authors.initials: C
authors.lastname: Zavos
authors.forename: Athanasios
authors.initials: A
authors.lastname: Beltsis
authors.forename: George
authors.initials: G
authors.lastname: Tzovaras
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010182:Pancreatic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome