ERCP is safe and effective in patients 80 years of age and older compared with younger patients

Fritz, Eva; Kirchgatterer, A; Hübner, Dietmar; Aschl, G; Hinterreiter, M.; Stadler, Bernhard; Knoflach, P

doi:10.1016/j.gie.2006.05.010

Cited by 96 publications

(101 citation statements)

References 24 publications

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“…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.…”

Section: Discussionsupporting

confidence: 91%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Huai²,

Sun³

2016

Turk J Gastroenterol

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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

Huai²,

Sun³

2016

Turk J Gastroenterol

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“…Age and severe complications were not related when the patient underwent gastroscopy + colonoscopy despite the doses of propofol It could be argued that complication rate in patients ≥ 80 years is not higher than in younger patients because the dose of propofol was significantly lower in those patients. This fact is shared by several studies comparing elderly and young people (7,20,27,28,35,36). This hypothesis is supported by the fact that, as we have observed, dose increase is the only risk factor to develop complications in patients ≥ 80 years.…”

Section: Discussionsupporting

confidence: 80%

“…The absence of differences regarding the development of sedation-related complications might be explained by the fact that we selected a healthy subgroup of octogenarians. However, these patients showed even higher co-morbidity than younger ones, what is also reflected in the increase of the ASA classification of anesthetic risk according to other studies (27)(28)(29)38). Moreover, in our study, among the 355 patients who needed anesthesiologist supervision only 8.2% were ≥ 80 year old and the differences between these patients and those who were not octogenarians were not significant.…”

Section: Discussioncontrasting

confidence: 56%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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Safety of continuous propofol sedation for endoscopic procedures in elderly patients

Martínez

Aparicio

Ruiz

et al. 2011

Rev. esp. enferm. dig.

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Objective: to evaluate safety of continuous propofol sedation in elderly patients who undergo endoscopic procedures and investigate risk factors to develop complications in the geriatric population.Material and methods: patients who received endoscopistdirected propofol sedation were classified into two groups according to age. Group I: > 80 years; Group II: < 80 years. Propofol was administered by continuous intravenous infusion to achieve deep sedation. Arterial oxygen saturation, heart rate, blood pressure, and electrocardiographic records were monitored during the procedure. Therapy and complications secondary to sedation were recorded.Results: one thousand two-hundred and ninety-five endoscopic procedures (gastroscopies, colonoscopies and endoscopic ultrasonographies) were included. The dose of propofol was lower and therapy was more frequently performed in Group I. There were no differences between sedation-related complications in both groups (Group I: 15.4%; Group II: 14%; p, NS). Patients in Group I showed greater tendency to develop severe oxygen desaturation in the colonoscopy and endoscopic ultrasonography procedures. In the univariate analysis, a higher dose of propofol was associated with the appearance of complications (157.4 ± 84.4 vs. 121.3 ± 89.6 mg) in elderly patients but it was not associated with severe oxygen desaturation.Conclusions: continuous propofol sedation during endoscopic procedures in elderly patients > 80 years is as safe as in younger patients.

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A nomogram for predicting stones recurrence in patients with bile duct stones undergoing laparoscopic common bile duct exploration

Xie

Yang

Zhou

et al. 2022

Annals of Gastroent Surgery

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Background The recurrence of bile duct stones is a long‐term outcome for patients undergoing laparoscopic common bile duct exploration (LCBDE) that is worthy of attention. This study aimed to investigate long‐term risk factors for stones recurrence after LCBDE and develop a nomogram for predicting the risk. Methods The clinical data on consecutive patients with bile duct stones undergoing LCBDE at Shanghai Tenth People's Hospital between January 2014 and February 2019 with a follow‐up period longer than 2 years were reviewed. Independent risk factors of stones recurrence identified by the Cox regression model were used to develop a nomogram in predicting stones recurrence after LCBDE. Results Eight hundred and twenty‐two patients were eventually included in this study. Of these patients, 42 (5.11%) developed stones recurrence. The cumulative incidences of stones recurrence at 1, 3, and 5 years after LCBDE were 1.34%, 4.36%, and 7.14%, respectively. Independent risk factors of stones recurrence were identified to be age (HR = 1.04, 95% CI = 1.02‐1.07), T‐tube drainage (HR = 3.28, 95% CI = 1.23‐8.72), fatty liver (HR = 2.69, 95% CI = 1.39‐5.20), urinary calculus (HR = 4.68, 95% CI = 2.29‐9.56), post‐cholecystectomy (HR = 5.21, 95% CI = 2.39‐11.33), and post‐ERCP + EST (HR = 2.87, 95% CI = 1.18‐6.96). By these factors, a developed nomogram showed a C‐index of 0.770 to predict stones recurrence. Conclusions The nomogram, based on identified risk factors, showed good accuracy for predicting stones recurrence, which is valuable to guide these patients’ follow‐up and prevention.

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ERCP is safe and effective in patients 80 years of age and older compared with younger patients

Cited by 96 publications

References 24 publications

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

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

Safety of continuous propofol sedation for endoscopic procedures in elderly patients

A nomogram for predicting stones recurrence in patients with bile duct stones undergoing laparoscopic common bile duct exploration

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