Is endoscopic retrograde cholangiopancreatography a reliable procedure in advanced age? A single tertiary center experience.

BACKGROUND

This study aimed to determine the reliability and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients compared with younger patients.

METHODS

In this retrospective study, ERCP procedures performed in our endoscopy unit between December 2020 and October 2024 were reviewed. Elderly patients aged ≥80 years (AA group) and younger patients aged <65 years (control group) were included. Their demographics, comorbidities, American Society of Anesthesiologists (ASA) scores, ERCP indications, procedural success, and complications were compared.

RESULTS

There were significant differences in ASA scores, comorbidities, and the use of anticoagulant or antiplatelet drugs between the groups (p<0.05, p<0.01, and p<0.05, respectively). Juxtapapillary diverticula were more common in the AA group than in the control group (21% vs. 5.1%, p<0.01). Regarding indications, choledocholithiasis and obstructive jaundice were the most common in both groups (p=0.456 and p=0.064, respectively). The rate of cannulation success was not significantly different between the groups (p=0.956). Sphincterotomy and stone extraction with balloon or basket were the most frequent interventions in both groups (p=0.22 and p=0.563, respectively). Postprocedural pancreatitis was significantly more common in the control group than in the AA group (p=0.041). No significant differences were found in other complications, including bleeding, perforation, infection, basket impaction, and cardiopulmonary events between the groups (p=0.436, p=0.354, p=0.958, p=0.254, and p=0.289, respectively).

CONCLUSION

Therapeutic ERCP procedures can be performed safely and efficiently in elderly patients, as their outcomes are comparable to those observed in younger patients.