Aging Clinical and Experimental Research

, Volume 28, Issue 4, pp 647–652 | Cite as

Is ERCP both effective and safe for common bile duct stones removal in octogenarians? A comparative study

  • Yi Lu
  • Lu Chen
  • Zheng Jin
  • Li-ke Bie
  • Biao Gong
Original Article



Some studies have investigated the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for octogenarians, but more and larger comparative studies are still needed.


From January 2008 to June 2011, patients who underwent ERCP for common bile duct stone removal were included and divided into three groups, based upon their age. Basic information, medical records, and ERCP operation notes were retrospectively reviewed.


868 patients were included, with 474 patients in Group 1 (<65 years old), 281 patients in Group 2 (≥65 years old and <80 years old), and 113 patients in Group 3 (≥80 years old). No difference was observed regarding the rate of complete stone removal and hospital stay among the three groups. Pancreatitis occurred more frequently in Group 1 than Group 3, and the incidence of pancreatitis in Group 2 had no statistical difference when compared with Group 1 or Group 3. The occurrence of biliary infection, hemorrhage, perforation, and other complications was not statistically different among the three groups. The mortality directly related to the ERCP procedure was zero (0).


ERCP is an effective and safe therapeutic method for stone removal in octogenarians, and age per se should not be a contraindication to endoscopic intervention.


Endoscopic sphincterotomy Endoscopic retrograde cholangiopancreatography Common bile duct stones Complication Octogenarians 


Compliance with ethical standards

Conflict of interest


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Siegel JH, Kasmin FE (1997) Biliary tract diseases in the elderly: management and outcomes. Gut 41:433–435CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Hacker KA, Schultz CC, Helling TS (1990) Choledochotomy for calculous disease in the elderly. Am J Surg 160:610–612 (discussion 613) CrossRefPubMedGoogle Scholar
  3. 3.
    Gronroos JM (2011) Clinical success of ERCP procedures in nonagenarian patients with bile duct stones. Minim Invasive Ther Allied Technol 20:146–149CrossRefPubMedGoogle Scholar
  4. 4.
    Fritz E, Kirchgatterer A, Hubner D et al (2006) ERCP is safe and effective in patients 80 years of age and older compared with younger patients. Gastrointest Endosc 64:899–905CrossRefPubMedGoogle Scholar
  5. 5.
    Ali M, Ward G, Staley D et al (2011) A retrospective study of the safety and efficacy of ERCP in octogenarians. Dig Dis Sci 56:586–590CrossRefPubMedGoogle Scholar
  6. 6.
    Katsinelos P, Paroutoglou G, Kountouras J et al (2006) Efficacy and safety of therapeutic ERCP in patients 90 years of age and older. Gastrointest Endosc 63:417–423CrossRefPubMedGoogle Scholar
  7. 7.
    Hui CK, Liu CL, Lai KC et al (2004) Outcome of emergency ERCP for acute cholangitis in patients 90 years of age and older. Aliment Pharmacol Ther 19:1153–1158CrossRefPubMedGoogle Scholar
  8. 8.
    Rodriguez-Gonzalez FJ, Naranjo-Rodriguez A, Mata-Tapia I et al (2003) ERCP in patients 90 years of age and older. Gastrointest Endosc 58:220–225CrossRefPubMedGoogle Scholar
  9. 9.
    Hu KC, Chang WH, Chu CH et al (2009) Findings and risk factors of early mortality of endoscopic retrograde cholangiopancreatography in different cohorts of elderly patients. J Am Geriatr Soc 57:1839–1843CrossRefPubMedGoogle Scholar
  10. 10.
    Mann S, Sripathy K, Siegler EL et al (2001) The medical interview: differences between adult and geriatric outpatients. J Am Geriatr Soc 49:65–71CrossRefPubMedGoogle Scholar
  11. 11.
    Sanson TG, O’Keefe KP (1996) Evaluation of abdominal pain in the elderly. Emerg Med Clin North Am 14:615–627CrossRefPubMedGoogle Scholar
  12. 12.
    Ashton CE, McNabb WR, Wilkinson ML et al (1998) Endoscopic retrograde cholangiopancreatography in elderly patients. Age Ageing 27:683–688CrossRefPubMedGoogle Scholar
  13. 13.
    Cocking JB, Ferguson A, Mukherjee SK et al (2000) Short-acting general anaesthesia facilitates therapeutic ERCP in frail elderly patients with benign extra-hepatic biliary disease. Eur J Gastroenterol Hepatol 12:451–454CrossRefPubMedGoogle Scholar
  14. 14.
    Chong VH, Yim HB, Lim CC (2005) Endoscopic retrograde cholangiopancreatography in the elderly: outcomes, safety and complications. Singapore Med J 46:621–626PubMedGoogle Scholar
  15. 15.
    De Palma GD, Catanzano C (1999) Stenting or surgery for treatment of irretrievable common bile duct calculi in elderly patients? Am J Surg 178:390–393CrossRefPubMedGoogle Scholar
  16. 16.
    Ito Y, Tsujino T, Togawa O et al (2008) Endoscopic papillary balloon dilation for the management of bile duct stones in patients 85 years of age and older. Gastrointest Endosc 68:477–482CrossRefPubMedGoogle Scholar
  17. 17.
    Talar-Wojnarowska R, Szulc G, Wozniak B et al (2009) Assessment of frequency and safety of endoscopic retrograde cholangiopancreatography in patients over 80 years of age. Pol Arch Med Wewn 119:136–140PubMedGoogle Scholar
  18. 18.
    Lukens FJ, Howell DA, Upender S et al (2010) ERCP in the very elderly: outcomes among patients older than eighty. Dig Dis Sci 55:847–851CrossRefPubMedGoogle Scholar
  19. 19.
    Mohammad Alizadeh AH, Afzali ES, Shahnazi A et al (2012) Utility and safety of ERCP in the elderly: a comparative study in Iran. Diagn Ther Endosc 2012:439320PubMedPubMedCentralGoogle Scholar
  20. 20.
    Obana T, Fujita N, Noda Y et al (2010) Efficacy and safety of therapeutic ERCP for the elderly with choledocholithiasis: comparison with younger patients. Intern Med 49:1935–1941CrossRefPubMedGoogle Scholar
  21. 21.
    Mitchell RM, O’Connor F, Dickey W (2003) Endoscopic retrograde cholangiopancreatography is safe and effective in patients 90 years of age and older. J Clin Gastroenterol 36:72–74CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Yi Lu
    • 1
  • Lu Chen
    • 1
  • Zheng Jin
    • 1
  • Li-ke Bie
    • 1
  • Biao Gong
    • 1
  1. 1.Digestive Endoscopy Center, Department of GastroenterologyRuijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina

Personalised recommendations