[Complications of endoscopic retrograde cholangiopancreatography in patients aged more than 90 years old].

BACKGROUND

To evaluate the effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) and the complication rates of this procedure in patients aged 90 years and older.

METHODS

A descriptive, prospective study including 42 endoscopic procedures performed from first January 2001 until first June 2004 in 36 patients (7 males and 29 females) was performed. The mean age was 91 years (range 90-96 years). All patients underwent the following: a) clinical evaluation before and after endoscopic exploration; b) evaluation of the success or failure of the endoscopic procedure and c) assessment of complications (perforation, hemorrhage, pancreatitis and infection). Concurrent associated illnesses, as well as the existence of anatomical alterations in Vaters papilla (duodenal diverticula), were also evaluated.

RESULTS

ERCP was successful in 85.7% of all explorations performed. Twenty-three patients (63.8%) had one or more major associated diseases. In 15 patients (33.3%) Vaters papilla was associated with duodenal diverticula. The complication rates were as follows: 1) acute pancreatitis in 2 explorations (4.7%), one mild (2.35%) and the other moderate (2.35%); 2) hemorrhage after endoscopic sphincterotomy in 2.8% of patients (1/35); 3) bacteriemia in one patient (2.3%) and cholangitis in one patient (2.3%), with no cases of secondary cholecystitis; 4) hypoxemia in one patient. There were no perforations or deaths related to the procedure.

CONCLUSIONS

ERCP is a safe and effective technique with a low complication rate in patients aged 90 years or older.