Comparatve Study on the Outcomes, Safety and Complicatons of ERCP in Elderly Patients: A Single Center Retrospectve Study

Abstract

Significance:
Endoscopic retrograde cholangiopancreatography (ERCP) has been a very useful diagnostic and therapeutic procedure in patients suffering from pancreaticobiliary disease. This has been increasingly seen among elderly Filipino patients. Because of significant co-morbidities accompanying advancing age, the elderly may be at greater risk of developing complications related to ERCP. This study aims to evaluate the outcomes, safety and complications associated with ERCP performed in the elderly patients 80 years old and above compared with young adult group.

Methodology:
A retrospective analysis of patients aged more than 80 years and young adults aged 18 - 35 years old referred for ERCP at Digestive Endoscopy Unit, Chinese General Hospital and Medical Center between January 2008 to June 2019, were reviewed from endoscopy database and medical records. The demographic profile, co-morbidities, indications, ERCP findings / interventions, outcomes, ERCP and medical-related complications were analyzed

Results:
Indications for ERCP were comparable in young and elderly groups. Underlying co-morbidities were common in elderly. The overall success rate was 90% in elderly group, whereas 96% in young adults. Most common cause of failed ERCP was due to failure of cannulation secondary to pancreatic head mass in elderly while a floppy papilla is a common cause of failed cannulation in the young adult group. Peri-procedural complications were similar in both age groups. Most common early ERCP-related complication was pancreatitis which was comparable in both age groups (both at 1.1%). Early and late complications in elderly were primarily due to other underlying medical conditions like coronary artery disease and pneumonia.

Conclusion:
ERCP-related complications were comparable between age groups. The study therefore conclude that ERCP for various indications is generally safe in elderly patients.