Urgent Endoscopic Retrograde Cholangiopancreatography Treatment Useful for Acute Cholangitis Caused by Bile Duct Stones in Patients Aged 90 Years and Older.

IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY
Gerontology Pub Date : 2024-09-30 DOI:10.1159/000541636
Hideaki Kazumori, Kousuke Fukuda, Koji Onishi, Yasuhiko Ohno
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引用次数: 0

Abstract

Background: Recently, the incidence of acute obstructive cholangitis caused by bile duct stones in patients aged 90 years and older (super-old) has been increasing, for which urgent endoscopic retrograde cholangiopancreatography (ERCP) treatment may be required. The aim of this study was to evaluate the efficacy and safety of urgent ERCP in super-old patients with acute cholangitis caused by bile duct stones.

Methods: A total 147 consecutive patients aged between 75 and 99 years who underwent urgent ERCP for acute cholangitis caused by bile duct stones were analyzed in a retrospective manner. They were divided into the old (age 75-89 years, control) and super-old (age 90-99 years) groups. Urgent ERCP efficacy and safety, including general status, ERCP-related findings and outcomes, cardiopulmonary monitoring during ERCP, and mortality, were compared between the groups.

Results: The physical status of the super-old group was worse than that of the old group. The success rates for biliary drainage and complete clearance of bile duct stones at the first attempt in the super-old group were lower as compared to the old group, while those after two attempts increased in the super-old group and were nearly the same as in the old group. No fatal cardiopulmonary complications during ERCP were observed in either group. Mortality rate within 2 months was higher in the super-old group, though recovered to the same level as in the old group after 2 months.

Conclusions: Efficacy and safety of urgent ERCP treatment in super-old patients were comparable to those seen in old patients, though the overall trend indicated greater difficulty. Urgent ERCP treatment can be useful for acute cholangitis caused by bile duct stones in super-old patients.

紧急内镜逆行胰胆管造影术有助于治疗 90 岁及以上患者因胆管结石引起的急性胆管炎。
背景:近来,90岁及以上高龄患者(超高龄患者)因胆管结石引起急性梗阻性胆管炎的发病率不断上升,可能需要进行紧急内镜逆行胰胆管造影术(ERCP)治疗。本研究旨在评估对胆管结石引起的急性胆管炎超高龄患者进行紧急ERCP治疗的有效性和安全性:方法:本研究以回顾性方式分析了因胆管结石引起急性胆管炎而接受急诊ERCP的年龄在75岁至99岁之间的连续147例患者。他们被分为高龄组(75 至 89 岁,对照组)和超高龄组(90 至 99 岁)。比较了两组患者的急诊ERCP疗效和安全性,包括一般状况、ERCP相关检查结果和疗效、ERCP期间的心肺监测以及死亡率:结果:超高龄组的身体状况比高龄组差。超高龄组首次胆道引流和完全清除胆管结石的成功率低于高龄组,而超高龄组在两次尝试后的成功率有所提高,几乎与高龄组相同。两组患者在ERCP过程中均未发现致命的心肺并发症。超高龄组在两个月内的死亡率较高,但在两个月后已恢复到与高龄组相同的水平:结论:超高龄患者紧急ERCP治疗的有效性和安全性与高龄患者相当,但总体趋势表明难度更大。紧急ERCP治疗对于超高龄患者因胆管结石引起的急性胆管炎很有帮助。
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来源期刊
Gerontology
Gerontology 医学-老年医学
CiteScore
6.00
自引率
0.00%
发文量
94
审稿时长
6-12 weeks
期刊介绍: In view of the ever-increasing fraction of elderly people, understanding the mechanisms of aging and age-related diseases has become a matter of urgent necessity. ''Gerontology'', the oldest journal in the field, responds to this need by drawing topical contributions from multiple disciplines to support the fundamental goals of extending active life and enhancing its quality. The range of papers is classified into four sections. In the Clinical Section, the aetiology, pathogenesis, prevention and treatment of agerelated diseases are discussed from a gerontological rather than a geriatric viewpoint. The Experimental Section contains up-to-date contributions from basic gerontological research. Papers dealing with behavioural development and related topics are placed in the Behavioural Science Section. Basic aspects of regeneration in different experimental biological systems as well as in the context of medical applications are dealt with in a special section that also contains information on technological advances for the elderly. Providing a primary source of high-quality papers covering all aspects of aging in humans and animals, ''Gerontology'' serves as an ideal information tool for all readers interested in the topic of aging from a broad perspective.
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