Endoscopy 2020; 52(S 01): S256-S257
DOI: 10.1055/s-0040-1704803
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Clinical endoscopic practice ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC ULTRASOUND (EUS) IN ELDERLY PATIENTS

S Bota
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
,
M Razpotnik
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
,
G Essler
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
,
J Weber-Eibel
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
,
M Peck-Radosavljevic
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims To assess the indications, safety and clinical utility of EUS in patients over 75 years of age.

Methods Our retrospective study included EUS investigations performed between 01/2015-10/2019 in our GI-Department, which features a centralized endoscopy-service in a University affiliated tertiary care teaching hospital.

Propofol and Midazolam were used for non-anesthesiologist sedation during endosonographies.

The following information was recorded:EUS indication, EUS type (diagnostic or interventional) and occurrence of complications(sedation-related or procedure-related).

Results 239/843(28.3%) of EUS performed were done in patients > 75 years and included in our analysis. These 239 EUS-examinations where performed in 219 patients with a mean age of 82.8 ± 4.9 years(39.7% male).

The main EUS indications were:suspicion of choledocholithiasis-43.5%, solid pancreatic masses-22.1%, subepithelial tumors-14.2% and pancreatic cystic lesions-8.8%.

Choledocholithiasis was diagnosed in 42.7% of suspected cases and confirmed by endoscopic retrograde cholangiopancreatography (ERCP).Only one patient (1.6%) with negative EUS needed ERCP in follow-up.

EUS diagnosed a biliary etiology in 2/4(50%) cases with initially acute pancreatitis of unknown etiology.

Interventions were performed in 69/239(28.8%) of the EUS-investigations. 76.8% of interventions were performed for pancreatic pathology(55.1% for solid pancreatic masses and 21.7% for pancreatic cysts).

Drainage of an infected cysts/walled-of necrosis was performed in 7.2% of interventional EUS. No complications were registered in these patients.

Overall complications were observed in 20/239 (8.4%)EUS-examinations.

Sedation related complication occurred in 10/239 (4.2%) of EUS. 9/10 patients suffered a transient, non-fatal respiratory insufficiency and one had hypotension. No intensive or respiratory care facility was needed.

Slight, spontaneously stopping intraluminal bleeding was observed in 13% of interventional EUS.

Conclusions EUS is safe and usefulness by patients over 75 years.EUS is very accurate for diagnosis of choledocholithiasis in these patients, avoiding unnecessary ERCPs and shortening of hospital stay. EUS drainage is safe and efficient in elderly patients with infected pancreatic cysts or walled-of necrosis.