Long-term Follow-up of Therapeutic ERCP in 78 Patients Aged 90 Years or Older

Abstract

This study aimed to determine the performance and long-term outcomes of therapeutic ERCP in very old patients. Patients aged or over 90 (Group A, n = 78) and consecutive sex-matched controls (Group B, n = 312) under 65 selected were compared. More patients in Group A had chronic concomitant diseases, but the success and complication rates were comparable. The follow-up of 61 patients (78.2%) in Group A were done, with a mean period of 27.5 (3–54) months. Seven patients survived; the main causes of death for the other patients were concomitant diseases (n = 43) and primary diseases (n = 11). In patients with choledocholithiasis, cases with complete extractions of stones in bile ducts survived longer than those without (30 vs. 24 months, P < 0.001). Therapeutic ERCP in patients aged 90 years or older is effective and safe. In patients with choledocholithiasis, complete clearance of stones is associated with longer survival time.

Endoscopic Retrograde Cholangiopancreatography in Nonagenarian Patients: Is It Really Safe?

“…Table 2 highlights the findings of identified studies evaluating the safety of ERCP in nonagenarian patients. Of the identified studies 5 had control groups [ 10 , 12 , 13 , 16 , 17 ]. These studies also failed to show any significant difference in the procedural success or composite adverse event rates in nonagenarian patients.…”

ERCP development in the largest developing country: a national survey from China in 2013

“…Furthermore, China is a region with a high prevalence of pancreaticobiliary diseases. [20][21][22][23][24] The ERCP rates of developed countries may not be the benchmark for China in the recent period, but the significant shortage in lessdeveloped and remote regions instigated our concern in this area. The most developed region in China, Shanghai, had an ERCP rate of 99.1 per 100,000 inhabitants, which was comparable with that in developed countries.…”

ERCP for biliary stones in the elderly: should we stop ducking the cholecystectomy?

“…While most studies to date have focused on the short-term complications of ERCP in the elderly, there is relatively little published data examining long-term outcomes in these patients. What data we do have suggest that complete treatment of biliary lithiasis may affect the overall survival of the elderly who require ERCP 14 . While the authors of Kenamori et al acknowledge that the broad time course of their study may have introduced unintended bias, it also permitted extended follow-up (a mean of 1278 days in the older cohort) in a fairly large number of patients.…”