Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin Medical School, 600 Highland Avenue, Madison, WI 53792-5124, USA.
Dig Dis Sci. 2010 Nov;55(11):3278-83. doi: 10.1007/s10620-010-1152-2. Epub 2010 Feb 26.
Further studies evaluating the safety of advanced endoscopic procedures in elderly patients are needed.
To evaluate the safety of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) in the elderly.
The study population, consisting of 1,000 patients who underwent ERCP or EUS, was divided into two cohorts. The elderly cohort consisted of patients ≥ 75 years old. The nonelderly cohort consisted of patients <75 years old. The data collected included demographic information, type of procedure completed, procedure medication used, and endoscopic intervention performed. Complications included any event which occurred during the procedure or up to 1 month post procedure.
A total of 600 ERCPs and 400 EUS were included. The mean age of the elderly cohort was 80 years (range 75-95 years, n = 184) versus 54 years (range 13-74 years, n = 816) for the nonelderly cohort. The ERCP complication rate was 10.0% in the elderly versus 10.6% (P = 1.0) for the nonelderly. The EUS complication rate was 4.8% in the elderly versus 3.1% in the nonelderly (P = 0.49). The overall complication rates were identical at 7.6% (P = 1.0). Sedation doses were lower for the elderly cohort (P < 0.001). There was a higher rate of procedure bleeding in the elderly cohort (P = 0.016).
Advanced age is not a contraindication for advanced endoscopic procedures. There is no significant increase in the rate of overall procedure-related complications seen with either ERCP or EUS in elderly patients; however, elderly patients have a higher risk of bleeding. Less procedure-related sedation medication is required for elderly patients.
需要进一步研究评估老年患者接受先进内镜治疗的安全性。
评估内镜逆行胰胆管造影术（ERCP）和内镜超声（EUS）在老年患者中的安全性。
研究人群包括 1000 例行 ERCP 或 EUS 的患者，分为两组。老年组由≥75 岁的患者组成。非老年组由<75 岁的患者组成。收集的数据包括人口统计学信息、完成的手术类型、手术中使用的药物和进行的内镜介入。并发症包括手术过程中或手术后 1 个月内发生的任何事件。
共纳入 600 例 ERCP 和 400 例 EUS。老年组的平均年龄为 80 岁（75-95 岁，n=184），非老年组的平均年龄为 54 岁（13-74 岁，n=816）。老年组的 ERCP 并发症发生率为 10.0%，非老年组为 10.6%（P=1.0）。老年组 EUS 并发症发生率为 4.8%，非老年组为 3.1%（P=0.49）。总的并发症发生率相同，为 7.6%（P=1.0）。老年组的镇静剂量较低（P<0.001）。老年组的手术出血发生率较高（P=0.016）。
高龄不是进行先进内镜治疗的禁忌证。老年患者接受 ERCP 或 EUS 时，总体手术相关并发症的发生率没有显著增加；然而，老年患者出血风险较高。老年患者需要较少的手术相关镇静药物。
