Retrospective Study of the Safety and Efficacy of ERCP in Octogenarians
Background Pancreatobiliary disease is increased in elderly patients. Because of significant comorbidities, these patients may be at greater risk of developing complications related to endoscopic retrograde cholangiopantreatography (ERCP). Objective The purpose of this study was to compare the indic...
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| Veröffentlicht in: | Digestive diseases and sciences 2011-02, Vol.56 (2), p.586-590 |
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| description | Background Pancreatobiliary disease is increased in elderly patients. Because of significant comorbidities, these patients may be at greater risk of developing complications related to endoscopic retrograde cholangiopantreatography (ERCP). Objective The purpose of this study was to compare the indications, interventions, and complications of ERCP of octogenarians with nonoctogenarians. Methods A retrospective review of patient records from a single tertiary care hospital was performed. Adult patients undergoing ERCP were divided into two groups according to age. Group 1 patients were of age < 80 years (N = 391), and group 2 patients were > 80 years of age (N = 102). Indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications were retrieved from the patient records. Main outcome measurements included: indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications. Results There was an increase in sphincterotomy rates (74 vs 63%; P < 0.05) and stent insertions (48 vs 29%; P < 0.001) in the octogenarian group. In group 1 there were 19 cases (4.9%) of post ERCP pancreatitis who spent 251 hospital days (including 59 ICU days) compared with one case (0.98%) in group 2 who required ten hospital days (P < 0.05) and 0 ICU days. Procedure time for octogenarians was greater than nonoctogenarians (33.1 vs 29.8 min; P < 0.05). Octogenarians required less conscious sedation than nonoctogenarians (midazolam 4.1 vs 5.9 mg; P < 0.05 and fentanyl 45.5 vs 80.4 mcg; P < 0.05). Conclusions In octogenarians, ERCP is efficacious and safe. It is associated with a lower rate of hospitalization for pancreatitis. ERCP in octogenarians takes longer, is associated with increased interventions (stent insertion and sphincterotomy) and requires less sedation. |
| doi_str_mv | 10.1007/s10620-010-1304-4 |
| format | Article |
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Because of significant comorbidities, these patients may be at greater risk of developing complications related to endoscopic retrograde cholangiopantreatography (ERCP). Objective The purpose of this study was to compare the indications, interventions, and complications of ERCP of octogenarians with nonoctogenarians. Methods A retrospective review of patient records from a single tertiary care hospital was performed. Adult patients undergoing ERCP were divided into two groups according to age. Group 1 patients were of age < 80 years (N = 391), and group 2 patients were > 80 years of age (N = 102). Indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications were retrieved from the patient records. Main outcome measurements included: indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications. Results There was an increase in sphincterotomy rates (74 vs 63%; P < 0.05) and stent insertions (48 vs 29%; P < 0.001) in the octogenarian group. In group 1 there were 19 cases (4.9%) of post ERCP pancreatitis who spent 251 hospital days (including 59 ICU days) compared with one case (0.98%) in group 2 who required ten hospital days (P < 0.05) and 0 ICU days. Procedure time for octogenarians was greater than nonoctogenarians (33.1 vs 29.8 min; P < 0.05). Octogenarians required less conscious sedation than nonoctogenarians (midazolam 4.1 vs 5.9 mg; P < 0.05 and fentanyl 45.5 vs 80.4 mcg; P < 0.05). Conclusions In octogenarians, ERCP is efficacious and safe. It is associated with a lower rate of hospitalization for pancreatitis. ERCP in octogenarians takes longer, is associated with increased interventions (stent insertion and sphincterotomy) and requires less sedation.]]></description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-010-1304-4</identifier><identifier>PMID: 20585982</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>Boston: Boston : Springer US</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Biliary Tract Diseases - diagnosis ; Biochemistry ; Biological and medical sciences ; Cholangiopancreatography, Endoscopic Retrograde - adverse effects ; Comorbidity ; Complications and side effects ; Conscious Sedation - statistics & numerical data ; Digestive system ; Endoscopic retrograde cholangiopancreatography ; Feeding. Feeding behavior ; Fundamental and applied biological sciences. Psychology ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatology ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Medical records ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Original Article ; Other diseases. Semiology ; Pancreatic Diseases - diagnosis ; Pancreatitis ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Retrospective Studies ; Sphincterotomy, Endoscopic - statistics & numerical data ; Stents - statistics & numerical data ; Time Factors ; Transplant Surgery ; Treatment Outcome ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Young Adult</subject><ispartof>Digestive diseases and sciences, 2011-02, Vol.56 (2), p.586-590</ispartof><rights>Springer Science+Business Media, LLC 2010</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 Springer</rights><rights>Springer Science+Business Media, LLC 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c524t-c969248e0ff799b6ab5e0aba987eb674770986fee841c4c1e4e6d2e6ec02ab303</citedby><cites>FETCH-LOGICAL-c524t-c969248e0ff799b6ab5e0aba987eb674770986fee841c4c1e4e6d2e6ec02ab303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-010-1304-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-010-1304-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23838181$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20585982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ali, Massud</creatorcontrib><creatorcontrib>Ward, Greg</creatorcontrib><creatorcontrib>Staley, Doug</creatorcontrib><creatorcontrib>Duerksen, Donald R</creatorcontrib><title>Retrospective Study of the Safety and Efficacy of ERCP in Octogenarians</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description><![CDATA[Background Pancreatobiliary disease is increased in elderly patients. Because of significant comorbidities, these patients may be at greater risk of developing complications related to endoscopic retrograde cholangiopantreatography (ERCP). Objective The purpose of this study was to compare the indications, interventions, and complications of ERCP of octogenarians with nonoctogenarians. Methods A retrospective review of patient records from a single tertiary care hospital was performed. Adult patients undergoing ERCP were divided into two groups according to age. Group 1 patients were of age < 80 years (N = 391), and group 2 patients were > 80 years of age (N = 102). Indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications were retrieved from the patient records. Main outcome measurements included: indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications. Results There was an increase in sphincterotomy rates (74 vs 63%; P < 0.05) and stent insertions (48 vs 29%; P < 0.001) in the octogenarian group. In group 1 there were 19 cases (4.9%) of post ERCP pancreatitis who spent 251 hospital days (including 59 ICU days) compared with one case (0.98%) in group 2 who required ten hospital days (P < 0.05) and 0 ICU days. Procedure time for octogenarians was greater than nonoctogenarians (33.1 vs 29.8 min; P < 0.05). Octogenarians required less conscious sedation than nonoctogenarians (midazolam 4.1 vs 5.9 mg; P < 0.05 and fentanyl 45.5 vs 80.4 mcg; P < 0.05). Conclusions In octogenarians, ERCP is efficacious and safe. It is associated with a lower rate of hospitalization for pancreatitis. ERCP in octogenarians takes longer, is associated with increased interventions (stent insertion and sphincterotomy) and requires less sedation.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biliary Tract Diseases - diagnosis</subject><subject>Biochemistry</subject><subject>Biological and medical sciences</subject><subject>Cholangiopancreatography, Endoscopic Retrograde - adverse effects</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Conscious Sedation - statistics & numerical data</subject><subject>Digestive system</subject><subject>Endoscopic retrograde cholangiopancreatography</subject><subject>Feeding. Feeding behavior</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gastroenterology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Medical records</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Other diseases. Semiology</subject><subject>Pancreatic Diseases - diagnosis</subject><subject>Pancreatitis</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Retrospective Studies</subject><subject>Sphincterotomy, Endoscopic - statistics & numerical data</subject><subject>Stents - statistics & numerical data</subject><subject>Time Factors</subject><subject>Transplant Surgery</subject><subject>Treatment Outcome</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Young Adult</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kU1v1DAQhiMEotvCD-ACEQjBJWXGcfxxrFbbglSpqKVny3HGS6rdZGsnSPvvcchCBULVHOzxPO947DfLXiGcIoD8FBEEgwIQCiyBF_xJtsBKlgWrhHqaLQBF2iOKo-w4xjsA0BLF8-yIQaUqrdgiu7imIfRxR25of1B-M4zNPu99PnxPifU07HPbNfnK-9ZZ96u0ul5-zdsuv3JDv6bOhtZ28UX2zNtNpJeH9SS7PV99W34uLq8uvizPLgtXMT4UTgvNuCLwXmpdC1tXBLa2WkmqheRSglbCEymOjjskTqJhJMgBs3UJ5Un2Ye67C_39SHEw2zY62mxsR_0YjeKqRM3YRH58lETNWeJQyoS-_Qe968fQpXekfrLSaWieoHcztLYbMm3n-yFYN_U0ZxKZ5ilYok7_Q6VoaNu6viPfpvO_BDgLXLIhBvJmF9qtDXuDYCaXzeyygSlPLptplNeHecd6S80fxW9bE_D-ANjo7MYH27k2PnClKhUqTBybuZhK3ZrCw8Mfu_3NLPK2N3YdUuPbm_SRJaAuBVRY_gSKJsPw</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Ali, Massud</creator><creator>Ward, Greg</creator><creator>Staley, Doug</creator><creator>Duerksen, Donald R</creator><general>Boston : Springer US</general><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>Retrospective Study of the Safety and Efficacy of ERCP in Octogenarians</title><author>Ali, Massud ; Ward, Greg ; Staley, Doug ; Duerksen, Donald R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c524t-c969248e0ff799b6ab5e0aba987eb674770986fee841c4c1e4e6d2e6ec02ab303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biliary Tract Diseases - diagnosis</topic><topic>Biochemistry</topic><topic>Biological and medical sciences</topic><topic>Cholangiopancreatography, Endoscopic Retrograde - adverse effects</topic><topic>Comorbidity</topic><topic>Complications and side effects</topic><topic>Conscious Sedation - statistics & numerical data</topic><topic>Digestive system</topic><topic>Endoscopic retrograde cholangiopancreatography</topic><topic>Feeding. Feeding behavior</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gastroenterology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Medical records</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Other diseases. Semiology</topic><topic>Pancreatic Diseases - diagnosis</topic><topic>Pancreatitis</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Retrospective Studies</topic><topic>Sphincterotomy, Endoscopic - statistics & numerical data</topic><topic>Stents - statistics & numerical data</topic><topic>Time Factors</topic><topic>Transplant Surgery</topic><topic>Treatment Outcome</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ali, Massud</creatorcontrib><creatorcontrib>Ward, Greg</creatorcontrib><creatorcontrib>Staley, Doug</creatorcontrib><creatorcontrib>Duerksen, Donald R</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ali, Massud</au><au>Ward, Greg</au><au>Staley, Doug</au><au>Duerksen, Donald R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Retrospective Study of the Safety and Efficacy of ERCP in Octogenarians</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>56</volume><issue>2</issue><spage>586</spage><epage>590</epage><pages>586-590</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><coden>DDSCDJ</coden><abstract><![CDATA[Background Pancreatobiliary disease is increased in elderly patients. Because of significant comorbidities, these patients may be at greater risk of developing complications related to endoscopic retrograde cholangiopantreatography (ERCP). Objective The purpose of this study was to compare the indications, interventions, and complications of ERCP of octogenarians with nonoctogenarians. Methods A retrospective review of patient records from a single tertiary care hospital was performed. Adult patients undergoing ERCP were divided into two groups according to age. Group 1 patients were of age < 80 years (N = 391), and group 2 patients were > 80 years of age (N = 102). Indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications were retrieved from the patient records. Main outcome measurements included: indications, therapeutic interventions, use of conscious sedation, duration of procedure and complications. Results There was an increase in sphincterotomy rates (74 vs 63%; P < 0.05) and stent insertions (48 vs 29%; P < 0.001) in the octogenarian group. In group 1 there were 19 cases (4.9%) of post ERCP pancreatitis who spent 251 hospital days (including 59 ICU days) compared with one case (0.98%) in group 2 who required ten hospital days (P < 0.05) and 0 ICU days. Procedure time for octogenarians was greater than nonoctogenarians (33.1 vs 29.8 min; P < 0.05). Octogenarians required less conscious sedation than nonoctogenarians (midazolam 4.1 vs 5.9 mg; P < 0.05 and fentanyl 45.5 vs 80.4 mcg; P < 0.05). Conclusions In octogenarians, ERCP is efficacious and safe. It is associated with a lower rate of hospitalization for pancreatitis. ERCP in octogenarians takes longer, is associated with increased interventions (stent insertion and sphincterotomy) and requires less sedation.]]></abstract><cop>Boston</cop><pub>Boston : Springer US</pub><pmid>20585982</pmid><doi>10.1007/s10620-010-1304-4</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Digestive diseases and sciences, 2011-02, Vol.56 (2), p.586-590 |
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| subjects | Adolescent Adult Age Factors Aged Aged, 80 and over Biliary Tract Diseases - diagnosis Biochemistry Biological and medical sciences Cholangiopancreatography, Endoscopic Retrograde - adverse effects Comorbidity Complications and side effects Conscious Sedation - statistics & numerical data Digestive system Endoscopic retrograde cholangiopancreatography Feeding. Feeding behavior Fundamental and applied biological sciences. Psychology Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen Hepatology Humans Investigative techniques, diagnostic techniques (general aspects) Liver. Biliary tract. Portal circulation. Exocrine pancreas Medical records Medical sciences Medicine Medicine & Public Health Middle Aged Oncology Original Article Other diseases. Semiology Pancreatic Diseases - diagnosis Pancreatitis Radiodiagnosis. Nmr imagery. Nmr spectrometry Retrospective Studies Sphincterotomy, Endoscopic - statistics & numerical data Stents - statistics & numerical data Time Factors Transplant Surgery Treatment Outcome Vertebrates: anatomy and physiology, studies on body, several organs or systems Young Adult |
| title | Retrospective Study of the Safety and Efficacy of ERCP in Octogenarians |
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