Is Endoscopic Retrograde Cholangiopancreatography Safe in Patients 90 Years of Age and Older?
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Background/Aims: This case-control study evaluated thesafety and efficacy of endoscopic retrograde cholangiopancreatography(ERCP) in patients 90 years of age and older. Methods: From January 2005 to August 2011, 5,070 casesof ERCP were performed at our institution. Of these, 43 casesinvolved patients 90 years of age and older (mean age,91.7±1.9 years). A control group of 129 cases (mean age,65.7±14.8 years) was matched by the patient sex, sphincterotomy,and presence of choledocholithiasis using a propensityscore. The patients’ medical records were retrospectivelyreviewed for comorbidity, periampullary diverticulum, urgentprocedure, conscious sedation, technical success, procedureduration, ERCP-related complication, and death. Results: Betweenthe case and control groups, there was no significantdifference with regard to comorbidity, periampullary diverticulum,and urgent procedure. Conscious sedation was performedsignificantly less in the patient group versus the controlgroup (28 [65%] vs 119 [92%], respectively; p=0.000). There was no significant difference in the technical success,procedure duration, or ERCP-related complications. In bothgroups, there was no major bleeding or perforation relatedto ERCP. Post-ERCP pancreatitis occurred significantly lessin the patient group compared to the control group (0 vs 13[10%], respectively; p=0.004). One death occurred from respiratoryarrest in the case group. Conclusions: ERCP can beperformed safely and successfully in patients aged 90 yearsand older without any significant increase in complications.
Abstract
Background/Aims: This case-control study evaluated thesafety and efficacy of endoscopic retrograde cholangiopancreatography(ERCP) in patients 90 years of age and older. Methods: From January 2005 to August 2011, 5,070 casesof ERCP were performed at our institution. Of these, 43 casesinvolved patients 90 years of age and older (mean age,91.7±1.9 years). A control group of 129 cases (mean age,65.7±14.8 years) was matched by the patient sex, sphincterotomy,and presence of choledocholithiasis using a propensityscore. The patients’ medical records were retrospectivelyreviewed for comorbidity, periampullary diverticulum, urgentprocedure, conscious sedation, technical success, procedureduration, ERCP-related complication, and death. Results: Betweenthe case and control groups, there was no significantdifference with regard to comorbidity, periampullary diverticulum,and urgent procedure. Conscious sedation was performedsignificantly less in the patient group versus the controlgroup (28 [65%] vs 119 [92%], respectively; p=0.000). There was no significant difference in the technical success,procedure duration, or ERCP-related complications. In bothgroups, there was no major bleeding or perforation relatedto ERCP. Post-ERCP pancreatitis occurred significantly lessin the patient group compared to the control group (0 vs 13[10%], respectively; p=0.004). One death occurred from respiratoryarrest in the case group. Conclusions: ERCP can beperformed safely and successfully in patients aged 90 yearsand older without any significant increase in complications.
참고문헌 (16)
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