Cagir Yavuz, Durak Muhammed Bahaddin, Simsek Cem, Yuksel Ilhami
Department of Gastroenterology, Ankara Bilkent City Hospital, Ankara 06800, Turkey.
Department of Gastroenterology, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey.
J Clin Med. 2024 Oct 14;13(20):6112. doi: 10.3390/jcm13206112.
The current study compared potential risks, complications, and the impact on clinical outcomes among elderly and younger patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Procedure-related complications, risk factors, and clinical outcomes following complications in elderly patients (aged ≥75 years) and younger who underwent biliary ERCP were evaluated. Median age of 63 (48-74) of 1164 patients who underwent biliary ERCP for the first time, and 266 (22.8%) were elderly. Comorbidities were statistically significant (81 [30.5%] versus 78 [8.7%], < 0.001), and periampullary diverticulum (PAD) was detected more commonly in the elderly group (79 [29.7%] vs. 103 [11.5%], < 0.001). There was no statistical difference in cannulation technique, cannulation time, and cannulation success in both groups, while the total ERCP procedure time was higher in the elderly group (22 [16-29] vs. 20 [14-29], = 0.030). Regarding the procedure-related complications, there was no statistically significant difference between the two groups (26 [9.8%] vs. 71 [7.9%], = 0.292). In the case of complications, the length of hospitalization stay was statistically longer in the elderly group. Moreover, the elderly had a longer length of hospitalization, experiencing pancreatitis and a higher probability of developing moderate/severe pancreatitis. In multivariate and univariate analysis, prolonged cannulation time was found to be an independent risk factor in patients ≥75 years of age. This study showed that while ERCP-related complication rates in elderly patients are comparable to younger patients, it can be associated with worse outcomes following the complication and prolonged length of hospitalization.
本研究比较了接受内镜逆行胰胆管造影术（ERCP）的老年患者和年轻患者的潜在风险、并发症以及对临床结局的影响。评估了老年患者（年龄≥75岁）和接受胆管ERCP的年轻患者的手术相关并发症、风险因素及并发症后的临床结局。1164例首次接受胆管ERCP的患者的中位年龄为63岁（48 - 74岁），其中266例（22.8%）为老年患者。合并症具有统计学意义（81例[30.5%]对78例[8.7%]，<0.001），且老年组壶腹周围憩室（PAD）的检出率更高（79例[29.7%]对103例[11.5%]，<0.001）。两组在插管技术、插管时间和插管成功率方面无统计学差异，而老年组的ERCP总手术时间更长（22分钟[16 - 29分钟]对20分钟[14 - 29分钟]，P = 0.030）。关于手术相关并发症，两组之间无统计学差异（26例[9.8%]对71例[7.9%]，P = 0.292）。发生并发症时，老年组的住院时间在统计学上更长。此外，老年患者住院时间更长，发生胰腺炎的概率更高，且发生中度/重度胰腺炎的可能性更大。在多因素和单因素分析中，发现插管时间延长是75岁及以上患者的独立危险因素。本研究表明，虽然老年患者ERCP相关并发症发生率与年轻患者相当，但并发症后的结局可能更差，住院时间更长。
