title: Safety and Efficacy of Acute Endoscopic Retrograde Cholangiopancreatography in the Elderly.
abstract: Endoscopic retrograde cholangiopancreatography (ERCP) is a frequent procedure in elderly patients.
  
  
  
  We aimed to determine the safety and efficacy of acute ERCP in older patients.
  
  
  
  A prospectively managed, hospital-based registry containing all ERCP procedures and complications at a tertiary referral center was used to form the study population, which consisted of consecutive elderly (≥65 years) patients undergoing acute ERCP during the 5-year study period. Indications, details, outcome, and complications of the procedure were analyzed in relation to patient age, gender, and co-morbidities.
  
  
  
  A total of 480 elderly patients (median age 78; range 65-97; 48 % men) underwent 531 ERCPs during the study period. The most common indications were bile duct stones (56.1 %) and biliary obstruction caused by malignancy (33.7 %). Successful stone extraction was achieved in 72.8 %, and with an additional, planned ERCP in 96.6 % of the patients. Post-ERCP complications developed in 3.4 % of the patients. These included pancreatitis in 1.7 %, hemorrhage in 0.6 %, and duodenal perforation in 0.2 % of the patients. One of these (0.2 %) was considered severe as this patient required invasive treatments and prolonged hospital stay. The risk of complications was associated with chronic obstructive pulmonary disease and difficult cannulation. Procedure-related mortality was zero, but overall 30-day mortality was 10 %, being 24 % in the patients with malignancy.
  
  
  
  ERCP can be safely and efficaciously performed on elderly patients. The high mortality should be taken into consideration when selecting therapeutic options.
authors: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland.
authors: Mika
authors: M
authors: Ukkonen
authors: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland.
authors: Antti
authors: A
authors: Siiki
authors: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland.
authors: Anne
authors: A
authors: Antila
authors: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland.
authors: Tuula
authors: T
authors: Tyrväinen
authors: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland.
authors: Juhani
authors: J
authors: Sand
authors: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland. johanna.laukkarinen@fimnet.fi.
authors: Johanna
authors: J
authors: Laukkarinen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D002769:Cholelithiasis / Q000601:surgery*; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D004386:Duodenum / Q000293:injuries; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D010195:Pancreatitis / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012042:Registries; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: Aged; ERCP; Elderly; Endoscopic retrograde cholangiopancreatography; Morbidity; Mortality