CONTRIBUTION OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN LITHIASIS PATHOLOGY IN THE ELDERLY OVER 75 YEARS : RESULTS OF A RETROSPECTIVE STUDY

Aims The aim is to determine the particularities and safety of ERCP in patients over 75 years old by comparing its results with those of younger subjects.

Methods A retrospective descriptive and analytical study was carried out from September 2002 to August 2021 including 122 patients, whose age was over 75 years and had undergone ERCP for lithiasis. Epidemiological, clinical and endoscopic data were collected, and compared with younger subjects results. Statistical analysis was performed using SPSS 20 software.

Results Among 1080 ERCPs performed for lithiasis pathology,12.6% were over 75 years old(n=122).There was a sex ratio (M/F) of 0.96 compared to 0.6 (p=0.014).

Endoscopic biliary sphincterotomy was performed in 94.3% of cases.

Primary vacuity of the main biliary duct was achieved in 64.8% of cases (compared to 78.8% in younger subjects;p=0.001), the use of additional endoscopic manoeuvres was 33.6% (18.5% in younger subjects), namely naso-biliary drain in 11.5%, sphincteroclase in 9.8%, prosthesis in 6.6%, mechanical lithotripsy in 3.3%, enlargement by endoscopic biliary sphincterotomy in 1.6%, and extracorporeal lithotripsy in 0.8%(p<0.001).

The early complication rate after ERCP was 6.6% compared to 5.6% (p=0.06).

The overall success rate was 88.4% compared to 92.5%(p=0,1).

In multivariate analysis, there was no significant difference in the efficacy of ERCP in lithiasis between subjects under and over 75 years old.

Conclusions Although the overall success rate remains better in younger subjects, the results of ERCP in lithiasis in elderly subjects over 75 years of age remain satisfying, with no statistically significant difference in terms of the effectiveness of ERCP.

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Artikel online veröffentlicht:
14. April 2022