Abstract
Background and Aims: There is no consensus, nor is there sufficient data, on the safety of endoscopic retrograde cholangiopancreatography in super-elderly patients. The demand for endoscopic retrograde cholangiopancreatography is increasing concurrently with the increasing human life expectancy. The aim of this study is, therefore, to assess the outcomes and safety of endoscopic retrograde cholangiopancreatography in super-elderly patients. Materials and Methods: The study sample consisted of 51 patients over 90 years of age who underwent endoscopic retrograde cholangiopancreatography between January 2014 and December 2018. Patients’ demographic characteristics, indications, procedure-, and anesthesia- related adverse events, American Society of Anesthesiologists classification, the presence of comorbidities, and outcomes were analyzed. The Charlson Comorbidity Index was used to analyze comorbidity. A cutoff of Charlson Comorbidity Index ≥2 was used to identify patients on the basis of comorbidities. Results: The mean age of the 51 included participants was 91.86 (Standard Deviation = 2.42) years, and 16 of them were male. Bile duct stones were the most frequent indication (66.7%). Sphincterotomy was performed on 42 participants (82.4%). A stent was used in 17 participants (33.3%). The rate of difficult cannulation was 23.5%. Nine (17.6%) and 12 (24%) participants had minor procedure- and anesthesia-related adverse events, respectively. The mean procedure time was 35.16 (Standard Deviation = 6.65) minutes. Overall success was 86.3%. In-patient mortality was not seen. Conclusion: Therapeutic endoscopic retrograde cholangiopancreatography is a safe and effective treatment for pancreatobiliary disorders in super-elderly patients. Age ≥90 and a Charlson Comorbidity Index ≥2 are independently associated with increased morbidity in patients undergoing endoscopic retrograde cholangiopancreatography, which is successful and well tolerated. Endoscopic retrograde cholangiopancreatography should remain the treatment of choice for super-elderly patients.
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