ERCP outcomes in an aging population: single-center observations

Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a critical procedure for diagnosing and treating biliary and pancreatic disorders, particularly in elderly populations where these conditions are prevalent. This study aims to evaluate the outcomes and complications of ERCP in an elderly cohort at a single center. Methods: This retrospective study included 169 patients who underwent ERCP, with a mean age of 66 years (range 19-92). The majority were female (51.5%). Indications, procedural success rates, and complications were analyzed, with a focus on the presence of periampullary diverticula and previous sphincterotomies. Results: The overall procedural success rate was 85.8%. The most common indication was cholangitis (63.9%), followed by biliary pancreatitis (15.4%) and asymptomatic choledocholithiasis (11.2%). Periampullary diverticula were present in 16.3% of patients, predominantly among older individuals. Difficult cannulation occurred in 20% of cases, with successful biliary cannulation achieved using various techniques. Stones were found in the common bile duct in 95% of patients and were successfully cleared in the same percentage. The overall complication rate was 13.8%, with bleeding (9.5%), pancreatitis (1.8%), and perforation (0.6%) being the most common. Complication rates were not significantly associated with age, gender, or the presence of diverticula, but were lower in patients with prior sphincterotomies. Conclusion: ERCP is effective in managing biliary and pancreatic diseases in elderly patients, with a high success rate and manageable complication profile. Prior sphincterotomy significantly reduces the risk of complications. These findings underscore the importance of experienced endoscopists and tailored approaches for elderly patients undergoing ERCP.