[Palliative minimally invasive therapy in inoperable elderly patients]

The results of palliative endoscopic therapeutic maneuvers in patients over 80 years of age were retrospectively analyzed, covering a time period of 26 months. Aims of the therapeutic modalities were the recanalization of stenoses of the gastrointestinal tract, the long-term enteral nutrition or the abolition of a malignant obstructive jaundice. Appropriate procedures were combined bougienage and laser therapy, implantation of esophageal bridging tubes, percutaneous endoscopic gastroenterostomy (PEG), and the implantation of biliary endoprosthesis after endoscopic papillotomy. We evaluated (during the period January 1, 1990 until February 29, 1992) a total of 89 patients with various diseases, all of whom, at the time of examination, were candidates for surgery, either due to the extent of a tumor or due to a significant reduction of the physical status. The complication rate of the procedures of 2.9%, and the lethality risk of 0.9% showed no increase compared to patients of younger age. Therefore, minimal invasive endoscopic therapeutic procedures are strongly indicated in inoperable patients suffering from various diseases. Symptoms may be eliminated or significantly reduced with a few procedures which can be repeated many times.