Safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography for patients over 90 years of age

• Published in: Geriatrics & gerontology international 2022-01, Vol.22 (1), p.50-55
• Main Authors: Zhang, Da‐ya, Zhai, Ya‐qi, Zhang, Guan‐jun, Chen, Sheng‐xin, Wu, Lang, Li, Ming‐yang
• Format: Article
• Language: English
• Subjects: Aged; aged 90 and over; Aged, 80 and over; cholangiopancreatography; Cholangiopancreatography, Endoscopic Retrograde - adverse effects; Cholangitis; efficacy; endoscopic retrograde; Humans; Pancreatitis - epidemiology; Retrospective Studies; safety
• ISSN: 1444-1586; 1447-0594
• DOI: 10.1111/ggi.14315

Aims This study aimed to explore the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in patients over 90 years of age. Methods The study included 176 patients aged over 85 years who received their ERCP from February 2002 to January 2021. In the case group (super‐elderly group), 44 patients were 90 years old or above. In the control group (younger group), there were 132 patients aged 85–89 years. The control group was matched according to patient gender and the same indications of ERCP at a 1:3 ratio. Logistic regression models were employed to evaluate all complications. Results The case group had higher acute physiology and chronic health evaluation scoring system (APACHE‐II) scores and rate of hypoalbuminemia. APACHE‐II scores (≥6 or 7) were significantly more common in the case group. The rates of technical success and complete success in the case group were 100% and 100% respectively, which were similar to the rates in the control group, namely a technical success rate of 98.5% and a complete success rate of 98.5%. The rate of complication in the case group was 9.1%, which was slightly lower than that of the control group (15.2%, P > 0.05). ERCP‐related death occurred in one patient in the control group, who had malignant biliary obstruction and died from cholangitis. There was no significant difference in the incidence of complications such as pancreatitis, hemorrhage, and infection between the two groups. In the multivariate analysis, the independent risk factor was Charlson Comorbidity Index (CCI) for overall complication. Conclusions ERCP can be performed safely and successfully in patients aged ≥90 years. Geriatr Gerontol Int 2022; 22: 50–55.