EUS and ERCP complication rates are not increased in elderly patients.
BACKGROUND
Further studies evaluating the safety of advanced endoscopic procedures in elderly patients are needed.


OBJECTIVE
To evaluate the safety of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) in the elderly.


METHODS
The study population, consisting of 1,000 patients who underwent ERCP or EUS, was divided into two cohorts. The elderly cohort consisted of patients ≥ 75 years old. The nonelderly cohort consisted of patients <75 years old. The data collected included demographic information, type of procedure completed, procedure medication used, and endoscopic intervention performed. Complications included any event which occurred during the procedure or up to 1 month post procedure.


RESULTS
A total of 600 ERCPs and 400 EUS were included. The mean age of the elderly cohort was 80 years (range 75-95 years, n = 184) versus 54 years (range 13-74 years, n = 816) for the nonelderly cohort. The ERCP complication rate was 10.0% in the elderly versus 10.6% (P = 1.0) for the nonelderly. The EUS complication rate was 4.8% in the elderly versus 3.1% in the nonelderly (P = 0.49). The overall complication rates were identical at 7.6% (P = 1.0). Sedation doses were lower for the elderly cohort (P < 0.001). There was a higher rate of procedure bleeding in the elderly cohort (P = 0.016).


CONCLUSIONS
Advanced age is not a contraindication for advanced endoscopic procedures. There is no significant increase in the rate of overall procedure-related complications seen with either ERCP or EUS in elderly patients; however, elderly patients have a higher risk of bleeding. Less procedure-related sedation medication is required for elderly patients.
Benson
Mark E
ME
Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin Medical School, 600 Highland Avenue, Madison, WI 53792-5124, USA. mb4@medicine.wisc.edu
Byrne
Siobhan
S
Brust
Donald J
DJ
Manning
Bradley
B
Pfau
Patrick R
PR
Frick
Terrence J
TJ
Reichelderfer
Mark
M
Gopal
Deepak V
DV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D042883:Choledocholithiasis / Q000175:diagnosis*; D016292:Procedural Sedation; D000075202:Contraindications; D019160:Endosonography / Q000009:adverse effects*; D004935:Esophageal Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D055815:Young Adult