The Efficacy And Safety For Emergency Endoscopic Retrograde Cholangiopancreatography For Acute Cholangitis In The Elderly

Objective:To study the efficacy and safety of endoscopic retrograde pancreatitis(ERCP)therapy in patients with acute cholangitis in elderly patients.Methods:From January 2013 to December 2015,emergency ERCPs were performed in 218 cases of acute cholangitis at our institution.Patients were classified as elderly,if they were aged 80 years and older(n = 62);controls were under the age of 80 years(n = 156).The patients' medical records were retrospectively reviewed for comorbidities,laboratory data,etiology of cholangitis(presence of biliary stones,biliary stricture and malignancy),details of the ERCP(therapeutic approaches,technical success rates,procedure duration),ERCP-related complications and mortality.Results:The frequency of comorbidities was higher in the elderly group than the control group(91.9%vs 67.3%).Periampullary diverticulum was observed in the elderly group at a higher frequency than the control group(24.2%vs 13.5%),Between the groups,there was no significant difference in the technical success rates(95.2%vs 95.5%)or endoscopic procedure durations.With regard to the frequency of ERCP-related complications,there was no significant difference between the two groups(8.1%vs 7.7%),except for a lower rate of post-ERCP pancreatitis in the elderly group than in the control group(1.6%vs 3.8%).Neither angiographic nor surgical intervention was required in any of the cases with ERCP-related complications.There was no mortality during the observational periods.Conclusion:Emergency ERCP for acute cholangitis can be performed safely even in elderly patients aged 80 years and older.