Volume 13 Supplement 1

Abstracts from the 26th National Congress of the Italian Society of Geriatric Surgery

Open Access

Endoscopic retrograde cholangiopancreatography in the elderly: a review of most recent personal experience

  • Giovanni D De Palma1Email author,
  • Bruno Amato1,
  • Saverio Siciliano1,
  • Francesco Maione1,
  • Dario Esposito1,
  • Nicola Gennarelli1,
  • Marcello Persico1,
  • Stefania Masone1,
  • Giuseppe Iannone1 and
  • Pietro Forestieri1
BMC Surgery201313(Suppl 1):A13

https://doi.org/10.1186/1471-2482-13-S1-A13

Published: 16 September 2013

Introduction

It is well documented that the incidence of biliary tract pathologies increases with age, and as life expectancy is rising, it is expected that the prevalence of advanced age patients with bile duct pathologies will correspondingly increase leading to an increase in the demand for endoscopic retrograde cholangiopancreatography (ERCP) interventions.

Our aims are to assess the outcomes, safety and complications associated with ERCP performed in an elderly population.

Methods

Patients aged 80 years or over referred for ERCP from January 2008 to December 2012, were identified and retrospectively reviewed.

Results

Eighty-three patients (58 females, mean age 84.6 ± 3.9 years old) underwent 94 procedures (1-3 procedures/patient). The main indications were cholangitis (53.7%), choledocholithiasis (19.4 %) and blocked stents (14.6 percent). Malignancies represented 12.3% of indications. The overall success rate was 92.5%. Minor events occurred in 19 patients (22.9%) percent (tachycardia 5, desaturation 11, transient hypotension 3). Major events occurred in 4 patients (4.8%): delayed post sphincterotomy bleeding (five days post-procedure) in 1 patient, cholangitis in 2, and one mild pancreatitis. Four deaths occurred within one month of ERCP, due to advanced malignancies.

Conclusion

Our study showed that ERCP is safe in the elderly population. Minor complications are usually transient and related to sedation, and mortality is usually related to severity of illness and underlying malignancies.

Authors’ Affiliations

(1)
Department of Gastroenterology, Endocrinology and Surgery. Center of Excellence for Technical Innovation in Surgery, University of Naples Federico II, School of Medicine

References

  1. Siegel HJ, Kasmin FE: Biliary tract diseases in the elderly: management and outcomes. Gut. 1997, 41: 433-5. 10.1136/gut.41.4.433.PubMed CentralView ArticlePubMedGoogle Scholar
  2. De Palma GD, Catanzano C: Stenting or surgery for treatment of irretrievable common bile duct calculi in elderly patients?. Am J Surg. 1999, 178 (5): 390-3. 10.1016/S0002-9610(99)00211-1.View ArticlePubMedGoogle Scholar
  3. Sugiyama M, Atomi Y: Endoscopic sphincterotomy for bile duct stones in patients 90 years of age and older. Gastrointest Endosc. 2000, 52: 187-91. 10.1067/mge.2000.107285.View ArticlePubMedGoogle Scholar
  4. Cardin F, Andreotti A, Manuel Zorzi M, Terranova C, Martella B, Amatoa B, Militello C: Usefulness of a fast track list for anxious patients in a upper GI endoscopy. BMC Surgery. 2012, 12 (Suppl 1): S11-doi:10.1186/1471-2482-12-S1-S11PubMed CentralView ArticlePubMedGoogle Scholar
  5. De Palma GD, Galloro G, Siciliano S, Catanzano C: Endoscopic stenting for definitive treatment of irretrievable common bile duct calculi. A long-term follow-up study of 49 patients. Hepatogastroenterology. 2001, 48 (37): 56-8.PubMedGoogle Scholar

Copyright

© De Palma et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Advertisement