Endoscopic Ultrasound in Patients Over 80 Years Old

Abstract

Background

The data on the safety and utility of EUS in patients over 80 years of age is limited.

Objective

We investigated the indications, feasibility, safety, and clinical utility of EUS in the management of GI, pancreatobiliary, and mediastinal diseases.

Design

Retrospective study.

Setting

A tertiary referral university hospital.

Patients

Consecutive patients ≥80 years of age referred over a 9-year period for EUS evaluation.

Results

A total of 265 EUS scans were performed in 232 patients with a mean age of 83.8 years. The indications for pancreatobiliary EUS were to evaluate a pancreatic mass (n = 60), pancreatic cyst (n = 18), pancreatitis (n = 10), dilated CBD in the setting of jaundice and/or biliary stricture (n = 20), dilated CBD with no jaundice and/or biliary stricture (n = 20). The indications for luminal gastrointestinal EUS were esophageal lesions (n = 21), gastric lesions (n = 30), duodenal lesions (n = 14), rectal lesions (n = 22), and gastrointestinal subepithelial lesions (n = 28). The indications for mediastinal EUS were mass/lymphadenopathy (n = 14). EUS-guided FNA (EUS-FNA) was performed in 95 (35.8%) cases and results were consistent or suspicious for a malignancy in 62 cases (65.2%). Endoscopic mucosal resection (EMR) was performed in 17 cases (6.41%) on the same session following endosonographic evaluation. The procedure was successful in all patients with no complications related to sedation, EUS, or EUS-FNA encountered. One patient had perforation following EMR.

Limitation

Retrospective study.

Conclusions

EUS and EUS-FNA are feasible and safe and have a significant impact on the management of GI, pancreatobiliary and mediastinal diseases in extreme elderly.