Is Endoscopic Retrograde Cholangiopancreatography Safe in Patients 90 Years of Age and Older?

Background/Aims: This case-control study evaluated the safety and efficacy of endoscopic retrograde cholangiopan-creatography (ERCP) in patients 90 years of age and older. Methods: From January 2005 to August 2011, 5,070 cases of ERCP were performed at our institution. Of these, 43 cases involved patients 90 years of age and older (mean age, 91.7 +/- 1.9 years). A control group of 129 cases (mean age, 65.7 +/- 14.8 years) was matched by the patient sex, sphincterotomy, and presence of choledocholithiasis using a propensity score. The patients' medical records were retrospectively reviewed for comorbidity, periampullary diverticulum, urgent procedure, conscious sedation, technical success, procedure duration, ERCP-related complication, and death. Results: Between the case and control groups, there was no significant difference with regard to comorbidity, periampullary diverticulum, and urgent procedure. Conscious sedation was performed significantly less in the patient group versus the control group (28 [65%] vs 119 [92%], respectively; p=0.000). There was no significant difference in the technical success, procedure duration, or ERCP-related complications. In both groups, there was no major bleeding or perforation related to ERCP. Post-ERCP pancreatitis occurred significantly less in the patient group compared to the control group (0 vs 13 [10%], respectively; p=0.004). One death occurred from respiratory arrest in the case group. Conclusions: ERCP can be performed safely and successfully in patients aged 90 years and older without any significant increase in complications.