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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(09): E1202-E1211
DOI: 10.1055/a-1216-1363
Original article

Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly

Ryunosuke Hakuta‡
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hirofumi Kogure‡
,
Yousuke Nakai
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
2   Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, Tokyo, Japan
,
Tsuyoshi Hamada
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Tatsuya Sato
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Yukari Suzuki
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Akiyuki Inokuma
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Sachiko Kanai
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Tomoka Nakamura
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Kensaku Noguchi
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Kazunaga Ishigaki
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Kei Saito
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Tomotaka Saito
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Naminatsu Takahara
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Suguru Mizuno
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Atsuo Yamada
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Minoru Tada
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Kazuhiko Koike
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Abstract

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) for patients with surgically altered anatomy is challenging. Recently, balloon endoscopy has been shown to facilitate ERCP for this population with a high technical success rate, but adverse events (AEs) are not uncommon. Compared to non-elderly patients, elderly patients may be at higher risk of AEs due to underlying comorbidities. The current study aimed to evaluate the feasibility of balloon endoscope-assisted ERCP (BE-ERCP) for the elderly.

Patients and methods We retrospectively identified patients who underwent BE-ERCP between January 2010 and September 2019. For patients who underwent multiple procedures during the study period, the first session was analyzed. Early AEs associated with BE-ERCP were compared between elderly (≥ 75 years) and non-elderly patients.

Results A total of 1,363 BE-ERCP procedures were performed, and 568 patients (211 elderly and 357 non-elderly) were included for the analyses. Technical success rates were high in both the elderly and non-elderly groups (80 % vs. 80 %, respectively). The rates of early AEs were similar between the groups (12 % vs. 9.0 % in the elderly and non-elderly group, respectively; P = 0.31). The mltivariable-adjusted odds ratio for early AEs comparing elderly to non-elderly patients was 1.36 (95 % confidence interval, 0.74–2.51; P = 0.32). Specifically, we did not observe between-group differences in rates of gastrointestinal perforation (2.4 % vs. 2.8 % in elderly and non-elderly groups, respectively; P = 0.99) and aspiration pneumonia (1.9 % vs. 0.6 %, P = 0.20).

Conclusions BE-ERCP is a feasible procedure for elderly individuals with surgically altered anatomy.



Publication History

Received: 29 February 2020

Accepted: 02 July 2020

Article published online:
31 August 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2020; 52(10): 936-936
DOI: 10.1055/a-1219-9240

 

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