Journals / Journal of Medicine and Palliative Care / 2025 / Volume: 6 Issue: 6

ERCP in the elderly: a comprehensive evaluation of procedural challenges and safety in a large single-center study

“Yaşlı hastalarda ERCP: büyük bir tek merkezli çalışmada işlemsel zorluklar ve güvenliğin kapsamlı değerlendirilmesi”

Yunus Halil Polat(Ankara Education and research hospital)0000-0002-2388-5388
Ahmet Yozgat(Ankara Education and research hospital)0000-0002-4414-9929
Pages
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Publication Date
2025-12-27
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings support the safety of ERCP in advanced age when performed by experienced endoscopists.

📌 3 Key Takeaways

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Objective & Hypothesis:Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is widely used for the diagnosis and treatment of biliary and pancreatic disorders.
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Key Findings & Data:While advanced age has been suggested as a risk factor for adverse events, data remain conflicting, particularly in patients aged ≥75 years.
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Conclusion & Impact:These findings support the safety of ERCP in advanced age when performed by experienced endoscopists.
🔬Design:Research Article
📍Scope:2021 Verileri
⚙️Variables:ERCP · elderly patients · endoscopic procedures

Abstract

Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is widely used for the diagnosis and treatment of biliary and pancreatic disorders. With the progressive aging of the global population, increasing numbers of elderly and very elderly patients undergo ERCP. While advanced age has been suggested as a risk factor for adverse events, data remain conflicting, particularly in patients aged ≥75 years. Methods: We retrospectively analyzed 943 patients who underwent ERCP between 2021 and 2024 at a tertiary care center. Patients were stratified into younger ( 10 min) and history of cholecystectomy were significantly associated with increased complication risk (p<0.001 and p=0.02, respectively). Conclusion: ERCP in elderly and very elderly patients is associated with longer procedural and hospitalization times, but not with increased complication rates. Advanced age alone should not be considered a contraindication for ERCP. Instead, procedure related factors such as cannulation duration and technical difficulty play a greater role in predicting adverse outcomes. These findings support the safety of ERCP in advanced age when performed by experienced endoscopists.

Özet

Arka Plan Endoskopik retrograd kolanjiyopankreatografi (ERCP), biliyer ve pankreatik hastalıkların tanı ve tedavisinde yaygın olarak kullanılmaktadır. Küresel nüfusun giderek yaşlanmasıyla birlikte, yaşlı ve ileri yaşlı hastalarda ERCP uygulamaları artmaktadır. İleri yaş, advers olaylar için bir risk faktörü olarak öne sürülse de, özellikle 75 yaş ve üzeri hastalarda veriler çelişkilidir. Yöntemler 2021–2024 yılları arasında üçüncü basamak bir sağlık merkezinde ERCP uygulanan 943 hasta retrospektif olarak analiz edildi. Hastalar genç ( 10 dakika) ve kolesistektomi öyküsü, artmış komplikasyon riski ile anlamlı ilişki gösterdi (sırasıyla p<0,001 ve p=0,02). Sonuç Yaşlı ve ileri yaşlı hastalarda ERCP, daha uzun işlem ve hastanede yatış süresiyle ilişkili olmakla birlikte, komplikasyon oranlarını artırmamaktadır. Bu nedenle, ileri yaş tek başına ERCP için kontrendikasyon olarak değerlendirilmemelidir. Advers sonuçların öngörülmesinde, yaş faktöründen ziyade kanülasyon süresi ve teknik zorluk gibi işleme bağlı değişkenler daha belirleyici görünmektedir. Bu bulgular, deneyimli endoskopistler tarafından uygulandığında ileri yaşta ERCP’nin güvenli olduğunu desteklemektedir.

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Cite This Article

Polat, Y. H., Yozgat, A. (2025). ERCP in the elderly: a comprehensive evaluation of procedural challenges and safety in a large single-center study. Journal of Medicine and Palliative Care, Volume: 6 Issue: 6. https://doi.org/10.47582/jompac.1810789

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References (17)

  1. Day LW, Lin L, Somsouk M. Adverse events in older patients undergoing ERCP: a systematic review and meta-analysis. Endosc Int Open. 2014; 2(1):E28-36. doi:10.1055/s-0034-1365281
  2. Mashiana HS, Jayaraj M, Liu X, Mohan BP, Azab M, Ohning G. Safety of ERCP in elderly patients: a systematic review and meta-analysis: 837. Am J Gastroenterol. 2017;112:pS471-S472.
  3. Iqbal U, Anwar H, Khan MA, et al. Safety and Efficacy of ERCP in nonagenarians: a systematic review and meta-analysis. Dig Dis Sci. 2022;67(4):1352-1361. doi:10.1007/s10620-021-06950-2
  4. Finkelmeier F, Tal A, Ajouaou M, et al. ERCP in elderly patients: increased risk of sedation adverse events but low frequency of post-ERCP pancreatitis. Gastrointest Endosc. 2015;82(6):1051-1059. doi:10.1016/j.gie.2015.04.032
  5. Tabak F, Wang HS, Li QP, et al. Endoscopic retrograde cholangiopancreatography in elderly patients: difficult cannulation and adverse events. World J Clin Cases. 2020;8(14):2988-2999. doi:10.12998/wjcc.v8.i14.2988
  6. Galeazzi M, Mazzola P, Valcarcel B, et al. Endoscopic retrograde cholangiopancreatography in the elderly: results of a retrospective study and a geriatricians' point of view. BMC Gastroenterol. 2018;18(1):38. doi: 10.1186/s12876-018-0764-4
  7. Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37(3):383-393. doi:10.1016/s0016-5107(91)70740-2
  8. Kiriyama S, Kozaka K, Takada T, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 2018;25(1):17-30. doi:10.1002/jhbp.512
  9. Wang L, Chen Z. Outcomes of therapeutic endoscopic retrograde cholangiopancreatography in elderly patients (≥80 years) with choledocholithiasis: a comprehensive meta-analysis. Dig Dis. 2025:1-22. doi:10.1159/000548378
  10. Li Z, Qiao Z, Wang W, Sun Y, Sun D, Sheng M. Breaking age barriers: the efficacy of ERCP in advanced age patients. BMC Surg. 2025;25(1):342. doi:10.1186/s12893-025-03083-5
  11. Cankurtaran RE, Ersoy O. Comparative analysis of ERCP results in two elderly cohorts: late elderly and super-aged patients. J Contemp Med. 2025;15(1):49-55.
  12. Baykan AR, Cerrah S, Çiftel S, Karahan B, Özdemir Y. Safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients aged 85 years and older: a single center experience. Turk J Surg. 2021; 37(2):162-168. doi:10.47717/turkjsurg.2021.5166
  13. Ding X, Zhang F, Wang Y. Risk factors for post-ERCP pancreatitis: a systematic review and meta-analysis. Surgeon. 2015;13(4):218-229. doi: 10.1016/j.surge.2014.11.005
  14. Lou L, Wang X, Zhang Y, et al. Prolonged cannulation time is an independent risk factor for moderate-to-severe post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis: a large cohort study. Ann Transl Med. 2023;11(5):188. doi:10.21037/atm-22-4697
  15. Goodman AJ. Impact of difficult biliary cannulation on post-ERCP pancreatitis: who is high risk, and is it time for a paradigm shift? Gastrointest Endosc. 2025;101(3):629-631. doi:10.1016/j.gie.2024.11.009
  16. Fung BM, Pitea TC, Tabibian JH. Difficult biliary cannulation in endoscopic retrograde cholangiopancreatography: definitions, risk factors, and implications. Eur Med J Hepatol. 2021;9(1):64-72.
  17. Lee YS, Cho CM, Cho KB, et al. Difficult biliary cannulation from the perspective of post-endoscopic retrograde cholangiopancreatography pancreatitis: identifying the optimal timing for the rescue cannulation technique. Gut Liver. 2021;15(3):459-465. doi:10.5009/gnl19304