TITLE

A retrospective study of the safety and efficacy of ERCP in octogenarians

AUTHOR(S)
Ali, Massud; Ward, Greg; Staley, Doug; Duerksen, Donald; Duerksen, Donald R
PUB. DATE
February 2011
SOURCE
Digestive Diseases & Sciences;Feb2011, Vol. 56 Issue 2, p586
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Background: Pancreatobiliary disease is increased in elderly patients. Because of significant comorbidities, these patients may be at greater risk of developing complications related to endoscopic retrograde cholangiopantreatography (ERCP).Objective: The purpose of this study was to compare the indications, interventions, and complications of ERCP of octogenarians with nonoctogenarians.Methods: A retrospective review of patient records from a single tertiary care hospital was performed. Adult patients undergoing ERCP were divided into two groups according to age. Group 1 patients were of age < 80 years (N = 391), and group 2 patients were > 80 years of age (N = 102). Indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications were retrieved from the patient records. Main outcome measurements included: indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications.Results: There was an increase in sphincterotomy rates (74 vs 63%; P < 0.05) and stent insertions (48 vs 29%; P < 0.001) in the octogenarian group. In group 1 there were 19 cases (4.9%) of post ERCP pancreatitis who spent 251 hospital days (including 59 ICU days) compared with one case (0.98%) in group 2 who required ten hospital days (P < 0.05) and 0 ICU days. Procedure time for octogenarians was greater than nonoctogenarians (33.1 vs 29.8 min; P < 0.05). Octogenarians required less conscious sedation than nonoctogenarians (midazolam 4.1 vs 5.9 mg; P < 0.05 and fentanyl 45.5 vs 80.4 mcg; P < 0.05).Conclusions: In octogenarians, ERCP is efficacious and safe. It is associated with a lower rate of hospitalization for pancreatitis. ERCP in octogenarians takes longer, is associated with increased interventions (stent insertion and sphincterotomy) and requires less sedation.
ACCESSION #
57580414

 

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