Safety And Efficacy Of ERCP In The Elderly Patients

Objective:To investigate the effect and safety of ERCP in Elder, Middle and Younger groups of patients.Methods:253 patients who received ERCP therapy between June 2010 and July 2011 were studied retrospectively.115 patients (45.5%) were under 65 years of age (Younger group), of which 79 patients (31.2%) were between 65 years of age and 80(Middle elder group),59 (23.3%) were more than 80 years old (Elder group). Data about ASA degree, clinical manifestations and biochemical index, ERCP procedures, diagnosis after ERCP, the status of pre-cut and cut papillotomy, complications and length of hospital stay after the surgery were recorded and compared.Results:8 patients of 253 cases who were undergone ERCP procedures were failed.178 patients were diagnosed of choledocholithiasis and 48 had malignant tumors.The rate of operational success was 96.8%(95.6%vs 97.4%vs98.3%). The overall successfull rate of stone extraction was 96.6%(96%vs 96.5%vs 97.8%). Elder group had a higher ASA degree than that in Younger and Middle groups(P<0.05). Laboratory findings were similar in all of the three groups. Papillotomy were performed in 186 patients (71.3%vs 73.4%vs78.0%). Pre-cut papillotomy were performed in 33 patients (16.5%vs6.3%vsl5.3%).27 patients had difficulty in intubating bile duct(13.0%vs 7.59%vs10.2%). The difference between the three groups was not statistically significant. The diagnosis of ERCP:Choledocholithiasis was 70.4%(65.2%vs72.2%vs78.0%). Malignant tumor was19.0%(15.7%vs 19.0%vs25.4%). Compared with that in the Younger group (28.7%), duodenal peripapilla diveniculum was more frequent in the two Elder groups patients (48.1%vs50.8%) (P<0.05). The days of the three groups after ERCP were 1.61±0.83,1.39±0.72,1.49±0.70. Post-procedural complications developed in 43(17.0%) patients. There were 25 (21.7%) complications in the Younger group. In contrast,8(10.1%) of the Middle group and 10 (16.9%) of the Elder group developed a complication.There were no serious complications and deaths.Conclusions:1. Although the ASA of the old is high, they can achieve the same effect with the young people. There are similar operational difficulties、outcomes and complications rate in elder, middle and younger patients.So ERCP is effective and safe in the elderly patients2. The two Elder groups patients were presented more duodenal peripapilla diveniculums than the Young group.