ERCP IN BILIARY STONES DISEASE: WHAT RESULTS FOR ELDERLY PATIENTS?

Aims:

The aim is to evaluate the indications and safety of ERCP in elderly subjects, and to compare the results with younger patients.

Methods:

From September 2002 to November 2018, we included 93 patients with biliary stones who underwent endoscopic drainage, in our department of Gastroenterology II. Patients older than 75 years were defined as elderly. Statistical analysis was performed by SPSS20 software.

Results:

Among 924 ERCP performed for biliary stones disease, 10.1% were over 75 years old (n = 93). The sex ratio M/F was 0.9%. 23.7% had a history of cholecystectomy (n = 22).5.4% had already endoscopic biliary sphincterotomy (n = 5). The indication for ERCP was acute biliary pancreatitis in 1.1% of cases (n = 1), acute cholangitis in 23.7% of cases (n = 22), a multiple large stones in 61.3% (n = 57). The diverticular papilla was present in 21.5% of cases (n = 20). Endoscopic biliary sphincterotomy was performed in 93.5% of cases (n = 87). We used additional maneuvers in 31.3% of cases, namely a naso-biliary drain in 14% (n = 13), mechanical lithotripsy in 4.3% (n = 4), extracorporeal lithotripsy in 1.1% (n = 1), enlargement of endoscopic sphincterotomy in 1.1% (n = 1), sphincteroclasy in 5.4% (n = 5), an endoprothesis was implanted in 5.4% (n = 5). The early complication rate post ERCP was 7.6%. The initial success rate was 62.4% (n = 58). The overall success rate was 88.2% (n = 82) compared to 92.3% for patients younger than 75 years of age (p= 0.1).

Conclusions:

Our study confirms that ERCP is a safe procedure in elderly patients, and that there is no difference in efficacy compared to younger patients.