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ERCP in patients 90 years of age and older
Francisco Javier Rodríguez-González1, Antonio Naranjo-Rodríguez, Inmaculada Mata-Tapia
1Gastroenterology Department, Hospital Reina Sofía, Córdoba, Spain.
Background:
Biliary diseases represent particular diagnostic and therapeutic problems in elderly patients.
Methods:
Patients 90 years of age or older who underwent ERCP from January 1993 to September 2001 were studied retrospectively.
Results:
A total of 126 patients underwent 147 ERCP procedures (range 1-5 per patient). Twelve additional ERCPs were performed in 9 of the patients during follow-up because of recurrent symptoms. A total of 159 procedures were, therefore, available for analysis. The most frequent indications were suspicion of bile duct stones (46.8%) and obstructive jaundice (35.7%). Midazolam (95.6%) was used for conscious sedation and hyoscine (74.8%) for duodenal ileus. Patient tolerance of the procedure was good in 92.4% of sessions. Diagnoses included bile duct stones (54%), bile duct dilatation without any apparent obstruction (11.9%), and malignant stenosis (9.5%). Therapeutic procedures were indicated in 95.6% of diagnosed patients and completed in 96.3% of cases. Complications occurred in association with 2.5% of the ERCP procedures; the procedure-related mortality rate was 0.7%.
Conclusions:
ERCP in elderly patients is practicable. The complication rate is low, and therapeutic efficacy is good.