title: Efficacy and safety of emergency endoscopic retrograde cholangiopancreatography for acute cholangitis in the elderly.
abstract: OBJECTIVE
  To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis.
  
  
  METHODS
  From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older (n= 102); controls were under the age of 80 years (n= 105). The patients' medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis (presence of biliary stones, biliary stricture and malignancy), details of the ERCP (therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality.
  
  
  RESULTS
  The frequency of comorbidities was higher in the elderly group than the control group (91.2%vs67.6%). Periampullary diverticulum was observed in the elderly group at a higher frequency than the control group (24.5%vs13.3%). Between the groups, there was no significant difference in the technical success rates (95.1%vs95.2%) or endoscopic procedure durations. With regard to the frequency of ERCP-related complications, there was no significant difference between the two groups (6.9%vs6.7%), except for a lower rate of post-ERCP pancreatitis in the elderly group than in the control group (1.0%vs3.8%). Neither angiographic nor surgical intervention was required in any of the cases with ERCP-related complications. There was no mortality during the observational periods.
  
  
  CONCLUSIONS
  Emergency ERCP for acute cholangitis can be performed safely even in elderly patients aged 80 years and older.
authors.affiliation: Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui, Fukui 918-8537, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Tohda
authors.affiliation: Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui, Fukui 918-8537, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohtani
authors.affiliation: Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui, Fukui 918-8537, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Dochin
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods*; D002761:Cholangitis / Q000601:surgery* / Q000628:therapy; D015897:Comorbidity; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology; D061214:Patient Safety; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Acute cholangitis; Comorbidity; Complication; Elderly; Endoscopic retrograde cholangiopancreatography