Age-related outcomes of digital single-operator cholangio-pancreatoscopy: a single-center retrospective study
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Marco Sacco1, Federica Mediati, Pietro Palmieri
1Gastroenterology Department, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
Background:
Digital single-operator cholangiopancreatoscopy (DSOC) is an important adjunct to endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and treatment of complex biliary and pancreatic diseases. However, data regarding its safety and efficacy in elderly patients remain limited.
Aim:
To evaluate the safety and efficacy of DSOC in patients aged 75 years compared with a younger population.
Methods:
We retrospectively analyzed consecutive patients who underwent ERCP with DSOC at a tertiary referral center between January 2017 and July 2025. Patients were stratified according to age (≥75 vs. <75 years). The primary outcome was procedure-related adverse events, defined according to American Society for Gastrointestinal Endoscopy criteria. Secondary outcomes included technical and clinical success rates and factors associated with complications.
Results:
A total of 136 patients underwent 170 DSOC procedures. Elderly patients had more comorbidities and higher American Society of Anesthesiologists scores compared with younger patients. Overall adverse event rates were comparable between elderly and younger patients (8 vs. 13%; P = 0.44), while technical and clinical success rates were high in both groups. Multivariate analysis showed that age was not independently associated with adverse events.
Conclusion:
In this retrospective single-center study, DSOC was feasible in selected elderly patients, with complication rates and procedural outcomes comparable to those of younger individuals. The lack of formal frailty assessment and procedural burden metrics limits generalizability to frail or unselected elderly populations. In this retrospective single-center study, DSOC was feasible in selected elderly patients, with complication rates and procedural outcomes comparable to those of younger individuals. The lack of formal frailty assessment and procedural burden metrics limits generalizability to frail or unselected elderly populations.
