Endoscopic retrograde cholangiopancreatography in elderly patients

Abstract

in elderly patients, common bile duct stones often present atypically and co-existence with malignancy is not unusual; ampullary carcinoma has a relatively good prognosis and ERCP is a safe and effective procedure in the management of biliary obstruction.

Use of the gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography cases under sedation/analgesia

“…ERCP is usually applied to patients in an advanced age group, possibly involving comorbidities (hypertension, heart diseases, diabetes, etc.) (5). For this reason, it is recommended to conduct the intervention with hemodynamic data monitoring and under deep sedation or general anesthetic (8,9).…”

Gallstone disease in the elderly: are older patients managed differently?

“…In addition, cholecystostomy was used more often for older patients overall, up to 14.6% for patients 85 years old and older. Although cholecystostomy provides a safe alternative to surgery for the critically ill and those with prohibitive comorbidity, it also is associated with significant recurrence rates when not followed by surgery, much the same as ERCP [8,9,12,[33][34][35]. Despite this, ERCP was used with surgery much less often in the older groups.…”

“…The majority of studies examining gallstone disease in the elderly have focused almost solely on outcomes of interventions including endoscopic retrograde cholangiopancreatography (ERCP) [4,8,9], percutaneous cholecystostomy [10][11][12][13] and, most often, surgery [14][15][16][17][18], generally for a more carefully selected group [19]. Only sparse reports exist on the management of elderly patients from the moment of presentation at the hospital with symptomatic biliary disease.…”

Advancing age is not a reason to withhold ERCP

“…Further studies are limited by their sample size. Ashton et al and Fritz et al report on ERCP outcomes in the over 80-year-old age group in 101 and 97 patients, respectively [13,14]. In contrast our results are based on ERCPs performed in 573 patients over the age of 80 years.…”