Efficacy and Safety of Therapeutic Endoscopic Retrograde Cholangiopancreatography in the Elderly Over 80 Years

Abstract

Therapeutic ERCP is comparable in terms of efficacy and safety between patients ≥80 years and those <65 years of age, although the elderly group had a higher rate of comorbid diseases and used anti-thrombotic drugs more frequently.

Risk factors of adverse events in endoscopic retrograde cholangiopancreatography for patients aged ≥85 years

“…Older people tend to have a higher rate of comorbid diseases and more frequent use of antithrombotic drugs. 7 A retrospective study showed that old age was a significant independent risk factor for more severe AE related to ERCP than those seen among younger patients. 19 According to the Tokyo Guideline 2013, moderate or severe acute cholangitis is an indication for prompt biliary drainage.…”

“…In previous reports, regarding the safety of ERCP for the older adults, most studies of therapeutic ERCP comparing older patients with younger patients have defined the age cut‐off for older patients as 70, 75 or 80 years. In most studies, investigators have reported that therapeutic ERCP was safe in older adults . However, there have been few reports on factors contributing to AE occurrence in ERCP for patients aged ≥85 years.…”

“…In most studies, investigators have reported that therapeutic ERCP was safe in older adults. [6][7][8][9] However, there have been few reports on factors contributing to AE occurrence in ERCP for patients aged ≥85 years. Further, although several studies have reported that ERCP was safe in patients aged ≥90 years, the control groups in several of them included younger patients.…”

Efficacy of midazolam‐ versus propofol‐based sedations by non‐anesthesiologists during therapeutic endoscopic retrograde cholangiopancreatography in patients aged over 80 years

“…ERCP in older patients may take a longer time because of increased interventions, such as stent insertion or multiple stone removal, and requires less sedation. However, the known overall complication and mortality rates are comparable to those of younger patients …”

“…However, the known overall complication and mortality rates are comparable to those of younger patients. [1][2][3][4][5][6][7] Cardiopulmonary unplanned events under conscious sedation constitute a major proportion of ERCP-related complications (5.4-21.6 of 1000 cases) and mortalities (0.3-0.5 of 1000 cases). 3,[8][9][10][11][12] Moreover, older patients are more responsive to sedative hypnotics for conscious endoscopic sedation.…”