Endoscopic retrograde cholangiopancreatography in elderly patients : Experience of a Tunisian department

Aims Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable therapeutic technique for pancreatobiliary diseases especially in elderly patients in whom surgery can be associated with a higher morbidity. However, evidence about its safety in the elderly is still debated.

The aim of our study was to determine the particularities and safety of ERCP in eldery patients (≥ 75 years old).

Methods This is a retrospective study conducted from january 2018 to December 2023 including patients who underwent ERCP in our department of gastro-enterology.

Patients were subdivided into two groups based on their age.

Group 1: age≥75 years old

Group 2: age<75 years old

Indications, outcomes and short-term complications of ERCP were compared within the two groups

Results Eight hundred and ten ERCPs were performed. Patients aged≥75 years old accounted for 25.2% of patients enrolled. An emergency ERCP was necessary in 93 patients in the group1 (45.6%) and 195 patients in the group 2 (32.4%) (p=0.01). The indications for ERCP were dominated in both groups by lithiasis of the bile ducts (40.2% in group 1 versus 37.5% in group 2), followed by pancreas tumors (16.2% in group 1 versus 15.8% in group 2).Main bile duct prosthesis was necessary in 23.5% of cases in group 1 and 24.9% in group 2 without significant difference (p=0.3). The failure rate of main bile duct catheterization was higher in the group1 (10.5% in group1 vs 7.3% in group2) (p=0.004). Post-ERCP complications occurred in 11.4% of patients in the first group and 7.7% in the second (p=0.43).

Conclusions Indications and safety during ERCP are comparable between patients aged 75 years old and over and those aged less than 75 years old. However, ERCP in eldery patients was more urgent with a higher failure rate.

Publication History

Article published online:
27 March 2025