Efficacy and safety of therapeutic ERCP in patients 90 years of age and older

Effectiveness and safety of biliary stenting in the management of difficult common bile duct stones in elderly patients

“…Furthermore, a more prolonged procedure duration may be necessary to completely remove large/multiple stones in these frail, elderly patients. In such individuals, temporary biliary stenting is a safe and effective alternative (11)(12)(13)(14)(15)(16)18,19). In the present study, we confirmed our previous experience and earlier reports that biliary stenting might be associated with a decrease in stone size and stone fragmentation (14)(15)(16) and also that indwelling double stents are superior to a single stent in maintaining the 3-month stent patency rate.…”

“…The following data were collected for each patient: age, gender, history of chronic concomitant conditions (19), clinical features, complications (ERCP-related (21) and stent-related), 3-month stent patency rate, and complete stone removal rate. The diameters (longitudinal/transverse) of the CBD stones for each patient before and after stenting were measured on the radiographs.…”

“…Importantly, short-term use of biliary stenting has been shown to be associated with reduction in stone size or fragmentation and serves as a bridge treatment to secondary intervention, thereby leading to easier stone removal at follow-up endoscopy (14)(15)(16)(17). Although several studies have reported that therapeutic ERCP plus stent placement is safe and effective for the elderly (18,19), data on the effectiveness and safety of this technique in elderly patients with difficult CBD stones is still limited.…”

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

“…In the present series, the incidence of PEP was 4% in the elderly and 5.2% in the younger group (Table 3), consistent with previous studies [17][18][19]; moreover, despite the higher prevalence of comorbidity in the elderly group, the severity of PEP was comparable to that observed in younger patients. Remarkably, in the well-recognized patient-(female sex, history of acute pancreatitis, SOD) and procedure-related (pancreatic opacification, precut access papillotomy) risk factors, no difference was found between the two groups.…”

“…Some studies have examined the safety of therapeutic ERCP in elderly patients and demonstrated that there is no statistically significant difference towards a higher complication rate in elderly patients, despite their higher comorbidity [17][18][19]. In this regard, the present study shows that the aging pancreatic changes do not influence the incidence and severity of PEP.…”