Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2016; 22(37): 8382-8388
Published online Oct 7, 2016. doi: 10.3748/wjg.v22.i37.8382
Efficacy and safety of emergency endoscopic retrograde cholangiopancreatography for acute cholangitis in the elderly
Gen Tohda, Masahiro Ohtani, Masaki Dochin
Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui, Fukui 918-8537, Japan
Masahiro Ohtani, Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Fukui 910-1193, Japan
Author contributions: Tohda G wrote the manuscript; Dochin M collected the data; and Ohtani M reviewed the manuscript.
Institutional review board statement: This study was conducted in accordance with the principles of the Declaration of Helsinki, and was reviewed ethically and approved by the Fukui Kosei Hospital Institutional Review Board.
Informed consent statement: All patients involved in this study gave their written informed consent about disclosure of their protected medical information.
Conflict-of-interest statement: Authors declare no conflict of interest relevant to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gen Tohda, MD, PhD, Department of Gastroenterology, Fukui Kosei Hospital, Shimo-rokujyo 201, Fukui, Fukui 918-8537, Japan. genkipapa178@yahoo.co.jp
Telephone: +81-776-413377 Fax: +81-776-413372
Received: June 25, 2016
Peer-review started: June 28, 2016
First decision: July 29, 2016
Revised: August 8, 2016
Accepted: August 23, 2016
Article in press: August 23, 2016
Published online: October 7, 2016
Abstract
AIM

To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis.

METHODS

From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older (n = 102); controls were under the age of 80 years (n = 105). The patients’ medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis (presence of biliary stones, biliary stricture and malignancy), details of the ERCP (therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality.

RESULTS

The frequency of comorbidities was higher in the elderly group than the control group (91.2% vs 67.6%). Periampullary diverticulum was observed in the elderly group at a higher frequency than the control group (24.5% vs 13.3%). Between the groups, there was no significant difference in the technical success rates (95.1% vs 95.2%) or endoscopic procedure durations. With regard to the frequency of ERCP-related complications, there was no significant difference between the two groups (6.9% vs 6.7%), except for a lower rate of post-ERCP pancreatitis in the elderly group than in the control group (1.0% vs 3.8%). Neither angiographic nor surgical intervention was required in any of the cases with ERCP-related complications. There was no mortality during the observational periods.

CONCLUSION

Emergency ERCP for acute cholangitis can be performed safely even in elderly patients aged 80 years and older.

Keywords: Acute cholangitis, Endoscopic retrograde cholangiopancreatography, Complication, Comorbidity, Elderly

Core tip: We retrospectively evaluated the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis. Patients who have undergone emergency ERCPs were classified as elderly group aged 80 years and older (n = 102) or controls under the age of 80 years (n = 105). The frequency of comorbidities was higher in the elderly group than the control group. However, there was no significant difference in the technical success rates, endoscopic procedure durations and ERCP-related complications between the two groups. There was no mortality during the observational periods. Emergency ERCP for acute cholangitis can be performed safely even in elderly patients.