Safety and Utility of Endoscopic Removal of Common Bile Duct Stones in the Elderly

Abstract

: We investigated the safety and utility of endoscopic removal of common bile duct stones CBDS in the elderly. In all, 253 patients with CBDS who underwent endoscopic retrograde cholangiopancreatography ERCP between January 2007 and December 2011 at Showa University Hospital were evaluated retrospectively. The median age of the patients was 75 years ; thus, we divided patients into two groups, those aged ≥ 75 years Group A ; n 134 and those aged 75 years Group B ; n 119 . Patients in Group A had signi cantly higher rates of endoscopic sphincterotomy in palliative ERCP 24.8% vs. 10.7% ; p 0.008 and palliative removal of CBDS 34.8% vs. 20.9% ; p 0.015 than patients in Group B. However, the median dose of unitrazepam was signi cantly lower for patients in Group A than Group B 1 vs. 1.4 mg, respectively ; p 0.001 . The rate of use of pentazocine 18.5% vs. 54.7% ; p 0.001 and scopolamine butylbromide 6.2% vs. 23.9% ; p 0.01 was signi cantly lower in Group A patients, whereas the use of glucagon was significantly higher in this group 43.8 vs. 15.4% ; p 0.001 . There were no signi cant differences in the rate of successful endoscopic removal of CBDS, treatment time, complications, and the recurrence of CBDS between the two groups. Endoscopic removal of CBDS in the elderly is a safe procedure with good outcomes if the appropriate treatment is selected.