Adverse Events of Single Balloon Enteroscopy-assisted Endoscopic Retrograde Cholangiopancreatography in the Elderly: A Propensity Score Matching Analysis

IF 1.5 Q4 GASTROENTEROLOGY & HEPATOLOGY

DEN open Pub Date : 2025-08-26 DOI:10.1002/deo2.70193

Hiroki Nakagawa, Tsuyoshi Takeda, Takeshi Okamoto, Takafumi Mie, Takaaki Furukawa, Takashi Sasaki, Masato Ozaka, Takahisa Matsuda, Yoshinori Igarashi, Naoki Sasahira

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Abstract

Background

Sedation for conventional endoscopic retrograde cholangiopancreatography (ERCP) has been reported to be safe even for elderly patients. However, the safety of sedation for balloon enteroscopy-assisted ERCP (BE-ERCP) has not been well-studied in the elderly.

Methods

We retrospectively analyzed consecutive patients with surgically altered anatomy who underwent their initial BE-ERCP using midazolam and pethidine at our institution between January 2016 and December 2022. The primary outcome was the rate of cardiopulmonary complications, including hypotension, bradycardia, tachycardia, and hypoxemia. Secondary outcomes included the rates of procedural interruptions, delayed arousal, postprocedural falls, and delirium, dose of sedatives, and rate of ERCP-related adverse events (AEs). Risk factors for cardiopulmonary complications and ERCP-related AEs were also examined.

Results

A total of 190 patients were included (elderly group: 63; non-elderly group: 127). After propensity score matching, 55 patients were selected for each group. The total dose of midazolam was significantly lower in the elderly group (4 mg vs. 5 mg, p = 0.033). Rates of cardiopulmonary complication (11% vs. 11%, p > 0.999) and ERCP-related AEs (6% vs. 9%, p = 0.716) were not significantly different between the two groups. The total dose of pethidine (> 35 mg) and total procedure time (≥ 51 min) were identified as risk factors for cardiopulmonary complications and ERCP-related AEs, respectively.

Conclusions

Cardiopulmonary complications and ERCP-related AEs were similar in elderly and non-elderly patients undergoing BE-ERCP. With careful monitoring, sedation during BE-ERCP appeared safe, even for elderly patients.

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老年人单气囊肠镜辅助内镜逆行胆管造影的不良事件：倾向评分匹配分析

背景：据报道，传统内镜逆行胆管造影（ERCP）中镇静是安全的，即使对老年患者也是如此。然而，在老年人中，镇静的安全性尚未得到很好的研究。方法回顾性分析2016年1月至2022年12月在我院使用咪达唑仑和哌啶进行首次BE-ERCP手术改变的连续患者。主要终点是心肺并发症的发生率，包括低血压、心动过缓、心动过速和低氧血症。次要结局包括手术中断、延迟唤醒、手术后跌倒和谵妄的发生率、镇静剂的剂量和ercp相关不良事件（ae）的发生率。心肺并发症和ercp相关ae的危险因素也被检查。结果共纳入190例患者，其中老年组63例，非老年组127例。经倾向评分匹配后，每组选择55例患者。老年组咪达唑仑总剂量显著低于对照组（4mg vs. 5mg, p = 0.033）。两组患者心肺并发症发生率（11% vs. 11%, p > 0.999）和ercp相关ae （6% vs. 9%, p = 0.716）无显著差异。哌啶总剂量（35 mg）和总手术时间（≥51 min）分别被确定为心肺并发症和ercp相关ae的危险因素。结论老年和非老年BE-ERCP患者的心肺并发症和ercp相关ae相似。在仔细的监测下，即使对老年患者，在BE-ERCP期间镇静也是安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

DEN open

CiteScore

1.30

自引率

0.00%

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