Cho Dae Hyeon, Park Geon Tae, Oh Ji Eun, Chung Chang Wook, Yoo Gil Jong, Kim Sung Rok, Shim Sang Goon
Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Korean J Gastroenterol. 2011 Dec;58(2):88-92. doi: 10.4166/kjg.2011.58.2.88.
BACKGROUND/AIMS: As the population ages, endoscopic retrograde cholangiopancreaticography (ERCP) is being used increasingly as a diagnostic and therapeutic tool for elderly patients with pancreatobiliary disease. The aim of this study was to assess the outcomes, safety and complications associated with ERCP performed in the elderly patients.
We retrospectively reviewed the medical record of 596 patients who were 50 years of age or older and underwent ERCP from January 2005 to September 2010. The patients were classified into two groups according to the age: non-elderly, 50-74 years old and elderly, ≥75 years old. Comparisons were made between two groups.
Five hundred and ninety-six patients (132 elderly and 464 non-elderly patients) were enrolled. The success rate of ERCP was 89.4% in the elderly and 91.9% in the non-elderly. The major complications were occurred in 11 patients of the elderly and 16 of the non-elderly, and the complication rate was significantly higher in the elderly compared to the non-elderly (8.3% vs. 3.4%, p=0.011). Pancreatitis occurred in 2 elderly patients and 10 non-elderly patients (1.5% vs. 2.1%, p=1.0). There was a higher rate of bleeding in the elderly patients (4.5% vs. 1.3%, p=0.01).
ERCP is effective and safe even in elderly patients. Outcomes of diagnostic and therapeutic ERCP in the elderly patients were similar to those in non-elderly patients. Elderly patients undergoing ERCP carried similar risk of pancreatitis but a higher risk of bleeding and perforation compared to non-elderly patients.
背景/目的:随着人口老龄化,内镜逆行胰胆管造影术(ERCP)越来越多地被用作老年胰胆疾病患者的诊断和治疗工具。本研究的目的是评估老年患者接受ERCP的疗效、安全性及并发症。
我们回顾性分析了2005年1月至2010年9月期间50岁及以上接受ERCP的596例患者的病历。根据年龄将患者分为两组:非老年组,年龄在50 - 74岁;老年组,年龄≥75岁。对两组进行比较。
共纳入596例患者(132例老年患者和464例非老年患者)。老年患者ERCP的成功率为89.4%,非老年患者为91.9%。老年组有11例发生主要并发症,非老年组有16例,老年组的并发症发生率显著高于非老年组(8.3%对3.4%,p = 0.011)。2例老年患者和10例非老年患者发生胰腺炎(1.5%对2.1%,p = 1.0)。老年患者出血率较高(4.5%对1.3%,p = 0.01)。
即使在老年患者中,ERCP也是有效且安全的。老年患者诊断性和治疗性ERCP的结果与非老年患者相似。与非老年患者相比,接受ERCP的老年患者发生胰腺炎的风险相似,但出血和穿孔的风险更高。