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

Ryunosuke Hakuta; Hirofumi Kogure; Yousuke Nakai; Tsuyoshi Hamada; Tatsuya Sato; Yukari Suzuki; Akiyuki Inokuma; Sachiko Kanai; Tomoka Nakamura; Kensaku Noguchi; Kazunaga Ishigaki; Kei Saito; Tomotaka Saito; Naminatsu Takahara; Suguru Mizuno; Atsuo Yamada; Minoru Tada; Kazuhiko Koike

doi:10.1055/a-1216-1363

Endoscopy International Open, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endoscopy 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‡

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Hirofumi Kogure‡

,

Yousuke Nakai

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

²Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, Tokyo, Japan

,

Tsuyoshi Hamada

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Tatsuya Sato

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Yukari Suzuki

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Akiyuki Inokuma

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Sachiko Kanai

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Tomoka Nakamura

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Kensaku Noguchi

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Kazunaga Ishigaki

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Kei Saito

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Tomotaka Saito

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Naminatsu Takahara

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Suguru Mizuno

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Atsuo Yamada

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Minoru Tada

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Kazuhiko Koike

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

› Institutsangaben

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.

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Referenzen

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