Efficacy and safety of endoscopic retrograde cholangiopancreatography in the treatment of elderly patients with acute cholangitis

Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of elderly patients with acute cholangitis. Methods A retrospective analysis on clinical data from 186 patients with acute cholangitis complicated with choledocholithiasis treated in Linfen Central Hospital from January 2015 to December 2018 was performed. Among them, 80 patients aged over or equal to 80 years were set as observation group, 106 patients aged less than 65 years old were set as control group. General information, comorbidities, ERCP operation and postoperative complications of the two groups were analyzed. Results The rates of hypertension, cerebrovascular disease and diabetes mellitus in the observation group were higher than those in the control group, and the differences were statistically significant (P 0.05). The rate of performing endoscopic sphincterotomy in the observation group (67.50%, 54/80) was greater than that in the control group (44.34%, 47/106), P 0.05). Four patients had failed intubation in the observation group, and their symptoms were improved by percuteneous transhepatic cholangio drainage. In the control group, five patients had failed intubation, and recovered after laparoscopic choledocholithotomy. There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusions Emergency ERCP is safe and effective in the treatment of elderly patients with acute cholangitis complicated with common bile duct stones, but close attention should be paid to comorbidities and early detection of possible adverse events. If elderly patients have severe complications, the management of perioperative period should be strengthened. Key words: Endoscopic retrograde cholangiopancreatography; Advanced age; Acute cholangitis; Complications