Clinical Features Of Elderly Patients With Therapeutic ERCP

Objective:To investigate the diagnosis and treatment of the first therapeutic ERCP in elderly patients over the age of 65 and realize the characteristics of therapeutic ERCP in elderly patients.Methods:Seven hundred and eighteen patients’ medical records who were in the first affiliated hospital of guangxi medical university and received their first therapeutic ERCP during October 2012 to December 2014 were retrospective analysised. Two hundred and sixty-eight patients was in the elderly patients group whose age was more than 65 years old. And 450 patients was in the non- elderly patients group whose age was between 18 and 65 years old.The differences of the comorbidity, postoperative complications, diagnosis and bile bacterial culture positive rate in therapeutic ERCP between the two groups was been compare with. And the clinical characteristics of elderly patients with therapeutic ERCP was been analysised.Results: ①The comorbidity such as hypertension (32.8%), coronary heart disease (7.5%), pneumonia (17.2%), COPD (1.5%) were more common in elderly patients group than in non-elderly patients group(P< 0.05);②Choledocholithiasis(60.4%) was the most common diagnosis in elderly patients group;③Thirty-eight cases (14.2%) with cholangiocarcinoma,27cases (10.1%) with acute biliary pancreatitis and 63 cases (23.5%)with juxtapapillary duodenal diverticula in elderly patients group were significantly more than the non-elderly patients group(P<0.05);④Eleven cases (4.1%) with hemorrhage,15 cases (5.6%) with the post ERCP hyperamylasemia,13 cases (4.9%) with the post ERCP acute pancreatitis were similar to the non-elderly patients group. The post ERCP complications rate in elderly group was similar to the non-elderly patients group (p>0.05); ⑤The bile bacterial culture positive rate (66.9%) was significantly higher than non-elderly group too (P< 0.05).Conclusions:The elderly patients has the following characteristics in the therapeutic ERCP: ①The comorbidity such as hypertension,coronary heart disease, pneumonia, COPD are more common in elderly patients;②Choledocholithiasis is the most common diagnosis in elderly patients group; ③The diagnosis of cholangiocarcinoma, acute biliary pancreatitis and juxtapapillary duodenal diverticula in elderly patients are significantly more than the non- elderly patients;④Therapeutic ERCP in elderly patients is safe;⑤The bile bacteria culture positive rate in elderly patients is higher.