Año 2024 / Volumen 116 / Número 5
Original
Endoscopic retrograde cholangiopancreatography for the management of choledocholithiasis in older patients

244-249

DOI: 10.17235/reed.2023.10051/2023

Júlia Gardenyes, Pere Roura, Helena Vallverdú-Cartie, Judit Hermoso-Bosch, Clàudia Roca, Mariona Espaulella, Antoni Casals, Héctor Ivo Marani, Joan Saló, Martín Galdín, Marta Gallach, Carles Leal,

Resumen
Background: older adults are increasing in number and frequently seek hospital care for acute illness. This study aimed to measure the utilization and safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients aged 85 and older in our hospital. Methods: a single-site, retrospective, observational and descriptive study was performed. Data about admissions and ERCP utilization was obtained from our hospital database. Medical and procedural records of patients aged 85 or older who underwent ERCP for choledocholithiasis between 2013 and 2019 were reviewed. Technical and medical adverse events after ERCP were evaluated. Results: four hundred and ninety-four ERCP due to choledocholithiasis were performed during the study period and 154 (31 %) patients were aged 85 or older; 567 (4.8 %) admissions due to biliary tract diseases were identified in the older population, and 27 % of cases required ERCP. In older patients, the rate of technical adverse events was around 10 %. There was no statistical difference between the older and younger groups regarding technical complications (8.8 vs 9.7 %; p = 0.7). Furthermore, in 36 % of cases, a medical event, decompensated comorbidity or geriatric syndromes appeared after ERCP. The overall mortality for any cause at six months was nearly 20 %, and the survival rate was significantly lower in patients who developed adverse events (technical or medical). Conclusions: in our hospital, ERCP is frequently used for patients aged 85 and older. Although technical adverse event rates are similar to those of younger adults, medical events appear frequently. We plan to strengthen our care plans for older adults and hope to reduce the medical complications experienced post-ERCP.
Resumen coloquial
The rise in life expectancy could be leading to an increased rate of admissions due to symptomatic bile duct stones in older patients, and the primary approach should be endoscopic retrograde cholangiopancreatography (ERCP). Our hospital uses the endoscopic procedure frequently in patients aged 85 and older. Although technical adverse event rates are similar to those of younger adults, medical events appear frequently. The survival rate is significantly lower in patients who develop any adverse event. We plan to strengthen our care plans for older adults and hope to reduce the medical complications experienced post ERCP.
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Bibliografía
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Instrucciones para citar
Gardenyes J, Roura P, Vallverdú-Cartie H, Hermoso-Bosch J, Roca C, Espaulella M, et all. Endoscopic retrograde cholangiopancreatography for the management of choledocholithiasis in older patients. 10051/2023


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Ficha Técnica

Recibido: 30/10/2023

Aceptado: 22/11/2023

Prepublicado: 30/11/2023

Publicado: 09/05/2024

Tiempo de revisión del artículo: 18 días

Tiempo de prepublicación: 31 días

Tiempo de edición del artículo: 192 días


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