Digestive Diseases and Sciences

, Volume 56, Issue 2, pp 586–590 | Cite as

A Retrospective Study of the Safety and Efficacy of ERCP in Octogenarians

  • Massud Ali
  • Greg Ward
  • Doug Staley
  • Donald R. DuerksenEmail author
Original Article



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).


The purpose of this study was to compare the indications, interventions, and complications of ERCP of octogenarians with nonoctogenarians.


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.


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).


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.


ERCP Elderly Pancreatitis Octogenarians 


  1. 1.
    Adams O. Life expectancy in Canada–an overview. Health Rep. 1990;2:361–376.PubMedGoogle Scholar
  2. 2.
    Fang R, Millar JS. Canada’s global position in life expectancy: a longitudinal comparison with the healthiest countries in the world. Can J Public Health. 2009;100:9–13.PubMedGoogle Scholar
  3. 3.
    Siegel JH, Kasmin FE. Biliary tract diseases in the elderly: management and outcomes. Gut. 1997;41:433–435.CrossRefPubMedGoogle Scholar
  4. 4.
    Hacker KA, Schultz CC, Helling TS. Choledochotomy for calculous disease in the elderly. Am J Surg. 1990;160:610–612.CrossRefPubMedGoogle Scholar
  5. 5.
    Katsinelos P, Paroutoglou G, Kountouras J, Zavos C, Beltsis A, Tzovaras G. Efficacy and safety of therapeutic ERCP in patients 90 years of age and older. Gastrointest Endosc. 2006;63:417–423.CrossRefPubMedGoogle Scholar
  6. 6.
    Clarke GA, Jacobson BC, Hammett RJ, Carr-Locke DL. The indications, utilization and safety of gastrointestinal endoscopy in an extremely elderly patient cohort. Endoscopy. 2001;33:580–584.CrossRefPubMedGoogle Scholar
  7. 7.
    Ashton CE, McNabb WR, Wilkinson ML, Lewis RR. Endoscopic retrograde cholangiopancreatography in elderly patients. Age Ageing. 1998;27:683–688.CrossRefPubMedGoogle Scholar
  8. 8.
    Talar-Wojnarowska R, Szulc G, Wozniak B, Pazurek M, Malecka-Panas E. Assessment of frequency and safety of endoscopic retrograde cholangiopancreatography in patients over 80 years of age. Pol Arch Med Wewn. 2009;119:136–140.PubMedGoogle Scholar
  9. 9.
    Fritz E, Kirchgatterer A, Hubner D, et al. ERCP is safe and effective in patients 80 years of age and older compared with younger patients. Gastrointest Endosc. 2006;64:899–905.CrossRefPubMedGoogle Scholar
  10. 10.
    Lukens FJ, Howell DA, Upender S, Sheth SG, Jafri SM. ERCP in the very elderly: outcomes among patients older than eighty. Dig Dis Sci. 2010;55(3):847–851.Google Scholar
  11. 11.
    Griniatsos J, Petrou A, Pappas P, et al. Percutaneous cholecystostomy without interval cholecystectomy as definitive treatment of acute cholecystitis in elderly and critically ill patients. South Med J. 2008;101:586–590.PubMedGoogle Scholar
  12. 12.
    Schutz SM, Abbott RM. Grading ERCPs by degree of difficulty: a new concept to produce more meaningful outcome data. Gastrointest Endosc. 2000;51:535–539.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Massud Ali
    • 1
  • Greg Ward
    • 1
  • Doug Staley
    • 2
  • Donald R. Duerksen
    • 1
    • 3
    Email author
  1. 1.Department of Internal MedicineUniversity of ManitobaWinnipegCanada
  2. 2.Office of Clinical ResearchSt. Boniface General HospitalWinnipegCanada
  3. 3.Department of Medicine, Division of GastroenterologySt. Boniface HospitalWinnipegCanada

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