Is endoscopic retrograde cholangiopancreatography a reliable procedure in advanced age? A single tertiary center experience.

Abstract

Background: This study aimed to determine the reliability and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients compared with younger patients.

Methods: In this retrospective study, ERCP procedures performed in our endoscopy unit between December 2020 and October 2024 were reviewed. Elderly patients aged ≥80 years (AA group) and younger patients aged <65 years (control group) were included. Their demographics, comorbidities, American Society of Anesthesiologists (ASA) scores, ERCP indications, procedural success, and complications were compared.

Results: There were significant differences in ASA scores, comorbidities, and the use of anticoagulant or antiplatelet drugs between the groups (p<0.05, p<0.01, and p<0.05, respectively). Juxtapapillary diverticula were more common in the AA group than in the control group (21% vs. 5.1%, p<0.01). Regarding indications, choledocholithiasis and obstructive jaundice were the most common in both groups (p=0.456 and p=0.064, respectively). The rate of cannulation success was not significantly different between the groups (p=0.956). Sphincterotomy and stone extraction with balloon or basket were the most frequent interventions in both groups (p=0.22 and p=0.563, respectively). Postprocedural pancreatitis was significantly more common in the control group than in the AA group (p=0.041). No significant differences were found in other complications, including bleeding, perforation, infection, basket impaction, and cardiopulmonary events between the groups (p=0.436, p=0.354, p=0.958, p=0.254, and p=0.289, respectively).

Conclusion: Therapeutic ERCP procedures can be performed safely and efficiently in elderly patients, as their outcomes are comparable to those observed in younger patients.