ERCP is safe and effective in patients 80 years of age and older compared with younger patients

Background: Biliary disease frequently occurs in the elderly, but there are limited data on ERCP in the elderly population. Patients: A total of 502 patients (group A, 97; group B, 405) underwent 724 ERCP procedures. Main Outcome Measurements: All consecutive ERCPs performed between 2000 and 2002 at a single center were retrospectively reviewed for patients :80 years old (group A) and patients < 80 years old (group B) to evaluate endoscopic findings, interventions, complications, and mortality related to complications. Results: The number of important chronic concomitant diseases was significantly higher in the older group (average per patient 1.08 vs 0.57, P < .001). Successful cannulation was achieved in 88% in group A versus 86% in group B, and endoscopic sphincterotomy was performed in 63.2% versus 51.4%. Periampullary diverticulum was found significantly more often in patients of group A (39.2%) than of group B (14.1%, P < .001). Stents were used in 24.1% of ERCP procedures in group A and in 22.9% in group B. There was no significant difference in the complication rate between group A (6.8%) and group B (5.1%) and in early mortality (1.03% vs 0.25%), respectively. Conclusion: ERCP is a safe and effective intervention in the elderly because complication and early mortality rates are comparable to those of younger patients, although comorbidity is significantly higher.