Title : Safety and challenges of endoscopic retrograde cholangiopancreatography among elderly patients (Interim analysis)
Abstract:
Introduction: The pancreaticobiliary diseases are common in the elderly. The prevalence of choledocholithiasis (bile duct stones) increases with age about four times compared with the younger population Endoscopic retrograde cholangiopancreatography (ERCP) is a routinely used diagnostic and therapeutic procedure for biliary and pancreatic diseases and is one of the most technically demanding and the high risk procedure which often obviates the need for emergency bilary tract surgery in the elderly which is comparatively better tolerated with less mortality.
Aim: To determine the safety and challenges of endoscopic retrograde cholangiopancreatography between patients of ≤60 years and ≥ 60 years.
Material and Methods:
Study Design: Cross sectional study conducted in Department of Gastroenterology, Liaquat National Hospital, Karachi.
Patient’s age is categorized into two age group as Group A i.e. ≤60 years and Group B i.e. ≥ 60 years.The procedures will be performed by endoscopist with similar experience. Standard video duodenoscopes with side view (Olympus, Tokyo, Japan) with 4.2 mm accessory channel caps will be used for endoscopic retrograde cholangiopancreatography operations.Patient’s data will be compiled and analyzed through statistical package for Social Sciences (SPSS) Version 25.
Sampling Technique: Non Probability Consecutive Sampling
Results: It’s an ongoing study with 54 patients.37 in group A and majority were females (68.5%) while 17 patients in group B with 64.7% females. Most frequently noted finding on ERCP in group A was CBD sludge 32.4 % followed by choledocholithiasis 29.7 % while in group B choledocholithiasis was 58.8% followed by malignant biliary stricture 17.6 %. Time taken by procedure in group A is 25.27+- 14.43 while group B 28.35+_14.9. Length of stay in hospital in group A 2.70+- 1.39 days while in group B 2.41+- 1.32 days. Complication noted in both groups is bleeding with group A 2.7 % and group b 5.9 % while outcome in terms of expiry group A 5.4 % and in group B 11.8 %.
Conclusion: Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and therapeutic procedure for biliary and pancreatic diseases and is a safe procedure with less number of complications.
Keywords: Endoscopic retrograde cholangiopancreatography(ERCP), choledocholithiasis(CBD STONES)
