Efficacy and safety of therapeutic ERCP in patients 90 years of age and older.
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.
Katsinelos
Panagiotis
P
Department of Endoscopy and Motility Unit, Central Hospital, Thessaloniki, Greece.
Paroutoglou
George
G
Kountouras
Jannis
J
Zavos
Christos
C
Beltsis
Athanasios
A
Tzovaras
George
G
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