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Observational Study
. 2018 Mar 14;18(1):38.
doi: 10.1186/s12876-018-0764-4.

Endoscopic Retrograde Cholangiopancreatography in the Elderly: Results of a Retrospective Study and a Geriatricians' Point of View

Free PMC article
Observational Study

Endoscopic Retrograde Cholangiopancreatography in the Elderly: Results of a Retrospective Study and a Geriatricians' Point of View

Marianna Galeazzi et al. BMC Gastroenterol. .
Free PMC article


Background: The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated.

Methods: We retrospectively analyzed the clinical records of all patients aged ≥65 undergoing ERCP between July 2013 and July 2015. Of 387 ERCP cases, 363 (~ 94%) were completed entirely. The mean age of the study population (n = 363) was 79.9 years old (range 70-95), with 190 subjects aged 70-79 and 173 older than 80. We recorded demographics, Charlson Comorbidity index (CCI), American Society of Anesthesiologists (ASA) physical status classification score, indication for the use of the ERCP procedure, and clinical outcomes. Then, we tested all variables to identify the potential risk factors for complications associated with the procedure.

Results: The older group (those ≥80 years old) showed significantly more patients with ASA Classes III-IV than the younger one (those ≤79 years old). Interestingly, the CCI was higher in the younger group (p = 0.009). The overall complication rate was 17.3% without inter-group differences. Older age, sex, CCI and intra-ERCP procedures were not related to a higher risk of complications, and the multivariate regression did not identify any of the considered variables to be an independent risk factor for complications.

Conclusion: ERCP appears as safe in the patients aged 80 years and older, as it is in those aged 70-79 years old in our study, however, a selection bias may affect these findings. A study including a comprehensive geriatric assessment will contribute to shedding light on this issue.

Keywords: ERCP; Elderly; Endoscopic retrograde cholangiopancreatography; Endoscopy; Procedural complications.

Conflict of interest statement

Ethics approval

The study was approved by the local ethics committee of University of Milano-Bicocca. All patients (or their legal representatives) signed an informed consent form to undergo the endoscopy procedure and for the use of their clinical data. Personal information has been de-identified according to the Italian legislation “Data Protection Code – Legislative Decree no. 196/2003.”

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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    1. Ukkonen M, Siiki A, Antila A, Tyrvainen T, Sand J, Laukkarinen J. Safety and efficacy of acute endoscopic retrograde cholangiopancreatography in the elderly. Dig Dis Sci. 2016;61:3302–3308. doi: 10.1007/s10620-016-4283-2. - DOI - PubMed
    1. Ali M, Ward G, Staley D, Duerksen DR. A retrospective study of the safety and efficacy of ERCP in octogenarians. Dig Dis Sci. 2011;56:586–590. doi: 10.1007/s10620-010-1304-4. - DOI - PubMed
    1. Lu Y, Chen L, Jin Z, Bie LK, Gong B. Is ERCP both effective and safe for common bile duct stones removal in octogenarians? A comparative study. Aging Clin Exp Res. 2016;28:647–652. doi: 10.1007/s40520-015-0453-x. - DOI - PubMed
    1. Day LW, Lin L, Somsouk M. Adverse events in older patients undergoing ERCP: a systematic review and meta-analysis. Endosc Int Open. 2014;2:E28–E36. doi: 10.1055/s-0034-1365281. - DOI - PMC - PubMed
    1. Holt BA. Increased severity of post-endoscopic retrograde cholangiopancreatography complications in the elderly: an issue to be addressed. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society. 2014;26:534–535. doi: 10.1111/den.12298. - DOI - PubMed

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