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- W2912059128 abstract "Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most complicated endoscopic procedures done by gastroenterologists and recently it has been increasingly used in elderly for various indications with good technical success. Advancing age is accompanied by increasing comorbid conditions when compared to younger age. The clinical outcomes and safety of ERCP in elderly, when compared with younger age, has varied among different studies. We aimed at doing a systematic review and meta-analysis of studies comparing the clinical outcomes of ERCP between the elderly and the younger age group.Table. AnalysisMethods: We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, EMBASE and Web of Science databases (from inception through April 2017) to identify studies that reported the comparison of ERCP-related outcomes in the elderly and the younger population. The primary outcome was to compare the overall rates of complications. The secondary outcome was to do a sub-group analysis for comparing individual adverse events including post-ERCP pancreatitis (PEP), hemorrhage and perforation. Results: 18 studies reporting on 2703 elderly and 7932 younger patients were identified. Lowest age cutoff for elderly population was 70 except for 1 study with age 65. The pooled event rates for overall complications in elderly population was 5.9% (95%CI=4.9%-7.0%) p-value < 0.05 and younger population was 7.4% (95%CI=6.8%-7.9%) p-value < 0.05, respectively. Sub-group analysis showed that the pooled rates of PEP, bleeding and perforation were 1.6% (95%CI=1.0%-2.6%) p-value < 0.05, 2.2% (95%CI=1.6%-3.0%) p-value < 0.05 and 1.0% (95%CI=0.6%-1.4%) p-value < 0.05 respectively in elderly and 2.9% (95%CI=2.3%-3.6%) p-value < 0.05, 2.0% (95%CI=1.7%-2.3%) p-value < 0.05 and 0.7% (95%CI=0.6%-0.9%) p-value < 0.05 respectively in the younger age group. Substantial heterogeneity was noted in the analysis. Conclusion: ERCP in elderly appears to be a safe procedure in comparison to younger age group. The increased overall complications rate in younger population could be related to the increased occurrence of PEP because of increased sensitivity of pancreas to trauma in the younger age group. Careful consideration should be given to the increased bleeding and perforation risk during ERCP in elderly.Figure" @default.
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- W2912059128 date "2017-10-01" @default.
- W2912059128 modified "2023-09-25" @default.
- W2912059128 title "Safety of ERCP in Elderly Patients: A Systematic Review and Meta-Analysis" @default.
- W2912059128 doi "https://doi.org/10.14309/00000434-201710001-00838" @default.
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