Introduction The ageing population in the UK means that biliary diseases are becoming more common. Endoscopic Retrograde Cholangiopancreatography (ERCP) is therefore increasingly being used as a therapeutic strategy. However, the elderly population often have associated co-morbidities and poorer physical health, which would suggest that ERCP may be technically more challenging, or of higher risk in this group. We look at the safety of ERCP in patients over 90.
Methods Patients aged 90 or above who underwent ERCP from October 1999 to October 2012 were studied retrospectively. The data was extracted from a single centre computer ERCP database.
Results ERCPs performed in patients aged 90 or above represented 6.5% of a total of 4017 procedures. The age range of patients was from 90 to 103 years. Therapeutic intervention was required in 246/262 procedures (93.9%). 16 specific types of intervention were performed, with the majority being sphincterotomy (62.2%) or stent insertion (16.7%). The procedure related mortality was 0.76% (2/262). 1 death occurred following a significant bleed post sphincterotomy, the other death resulted from a retroperitoneal perforation following duodenal dilatation. Complications occurred in 5.3% (14/262) of procedures. The most frequently occurring complications were bleeding and cholangitis, each of which occurred in 3/262 (1.1%) patients. Perforation occurred in 2/262 patients (0.76%). Pancreatitis did not occur in any of the patients. There were no complications related to co-morbidity.
Conclusion The number of ERCPs being performed in elderly patients is likely to increase. The procedure related mortality and morbidity is comparable with national figures. ERCP in this group is safe, practical and has a definite therapeutic benefit in a large proportion of patients.
Disclosure of Interest None Declared.
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