ERCP in patients 90 years of age and older.
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Resumo
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.
