ERCP in patients 90 years of age and older

Safety of continuous propofol sedation for endoscopic procedures in elderly patients

“…While some experts are against sedation due to its potential adverse events and to the acceptable tolerance to endoscopic procedures by elderly patients (12,21), several studies support safety of sedation in the geriatric population (5,18,(22)(23)(24)(25)(26). Further, it has been recently published that detection rate of neoplastic lesions (its prevalence increases as we get older) is partially depended on the use of sedation(33) so necessity for sedation in endoscopic procedures is strengthened, specially in the geriatric population.…”

“…There is no specific antidote for propofol (4). Despite this fact, safety of propofol sedation in endoscopic procedures, even without anesthesiologist assistance, has been shown in numerous studies (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

“…Though this group of patients shows better tolerance to endoscopic procedures without sedation (18,21), several studies suggest that conscious and deep sedation are safe (5,18,(22)(23)(24)(25)(26). Moreover, some authors have suggested that the use of propofol by the endoscopy unit personnel may be efficient and safe even in elderly patients (5,(26)(27)(28)(29)(30), but the use of continuous propofol infusion in these group of patients is not reported.…”

The impact of age on the incidence and severity of post-endoscopic retrograde cholangiopancreatography pancreatitis

“…Although many studies [2,4,8] have reported that therapeutic ERCP can be performed with safety in patients of advanced age, there are no reports regarding the potential effect of the aging pancreatic changes on the incidence and severity of PEP. Therefore, the aim of the present study was to investigate the impact of old age (>75 years) and its associated pancreatic changes on the clinical outcomes and adverse events following ERCP in terms of the incidence and severity of PEP.…”

“…Therefore, endoscopic retrograde cholangiopancreatography (ERCP) would be increasingly required in elderly patients. ERCP is less invasive than surgery, but is a highly effective procedure that has played a major role in the management of biliary and pancreatic diseases in patients of advanced age [2]. Therapeutic ERCP has become an almost exclusively endoscopic therapeutic procedure for biliary and pancreatic diseases and it is a potentially life- saving intervention for the elderly population [3,4].…”