Abstract
BackgroundThe incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated.MethodsWe retrospectively analyzed the clinical records of all patients aged ≥65 undergoing ERCP between July 2013 and July 2015. Of 387 ERCP cases, 363 (~ 94%) were completed entirely. The mean age of the study population (n = 363) was 79.9 years old (range 70–95), with 190 subjects aged 70–79 and 173 older than 80. We recorded demographics, Charlson Comorbidity index (CCI), American Society of Anesthesiologists (ASA) physical status classification score, indication for the use of the ERCP procedure, and clinical outcomes. Then, we tested all variables to identify the potential risk factors for complications associated with the procedure.ResultsThe older group (those ≥80 years old) showed significantly more patients with ASA Classes III-IV than the younger one (those ≤79 years old). Interestingly, the CCI was higher in the younger group (p = 0.009). The overall complication rate was 17.3% without inter-group differences. Older age, sex, CCI and intra-ERCP procedures were not related to a higher risk of complications, and the multivariate regression did not identify any of the considered variables to be an independent risk factor for complications.ConclusionERCP appears as safe in the patients aged 80 years and older, as it is in those aged 70–79 years old in our study, however, a selection bias may affect these findings. A study including a comprehensive geriatric assessment will contribute to shedding light on this issue.
Highlights
The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages
We considered only Endoscopic Retrograde Cholangiopancreatography (ERCP) performed in patients ages 65 and older, and divided the study population into two groups according to the age criterion (65–79 vs. ≥80)
Patients’ characteristics Seven hundred and thirty-two ERCPs were performed at San Gerardo Hospital from July 1st 2013 to July 31st 2015
Summary
The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated. The incidence of biliary tract pathology is growing due to the overall aging of the population worldwide, and this is evident among the number of those over the age of 801. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard exploratory technique for the treatment of biliary or Galeazzi et al BMC Gastroenterology (2018) 18:38 undergo a comprehensive approach to be characterized. Our aim was to assess how the specialists in endoscopy evaluate patients undergoing ERCP, the success rate of this procedure, and the incidence of complications in octogenarians compared to that of younger seniors (aged < 80 years old)
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