Safety of day-care therapeutic endoscopic retrograde cholangiopancreatography and endoscopic ultrasound in the oldest old patients: A case series

Abstract

In the modern era, endoscopic retrograde cholangiopancreatography (ERCP) and therapeutic endoscopic ultrasound (EUS) are increasingly being performed in day-care settings. The safety of these procedures in elderly admitted patients has been established in previous studies, but evidence for the safety of day-care ERCP/therapeutic EUS is limited. We retrospectively analyzed the outcomes of day-care ERCP/EUS in patients more than 80 years of age. All procedures were done under total intravenous anesthesia (ketamine- and propofol-based) and the intra-procedural and immediate postprocedural complications (within 6 hours) were noted. Thirty patients (24 male and 6 female) were enrolled. The most common indication for the procedure was choledocholithiasis (46.6%), followed by malignant stenosis (30.0%) and benign strictures (20.0%). One patient had transient desaturation during the procedure and two patients had hypotension. The dreaded complications of bleeding, perforation, or pancreatitis did not occur in any patients, and none required admission. In conclusion, day-care therapeutic ERCP/EUS is safe and cost-effective in the oldest old patients.

Keywords

• cholangiopancreatography
• endoscopic retrograde; daycare; oldest old; safety; therapeutic endoscopic ultrasound