ERCP in Patients Over Ninety Years-Old- A Safety and Efficacy Comparison with a Younger Cohort

Introduction: As life expectancy increases worldwide, so is the prevalence of biliary tract and pancreatic disorders resulting in a rising demand for invasive procedures such as ERCP in the elderly. Few studies have assessed the safety of ERCP in patients 90 years and older particularly among the Hispanic population. The primary aim of this study was to determine the technical success and adverse events associated with ERCP in patients 90 years of age or older in comparison to a younger cohort of patients. Methods: A retrospective analysis of all ERCPs done at our institution from 2012 to 2018 was performed. Three hundred ERCPs in patients < 90 years-old and all 28 ERCPs done in patients ≥ 90 years old were included in the analysis. Results: ERCPs were successfully completed in 96.4% of patients >90 y/o and 96.3% of the <90 y/o cohort (RR 1.00, CI 0.92-1.07). There was no difference in the rate of periprocedural adverse events. Post-ERCP adverse events occurred in 7.1% and 3.0% in >90 and <90, respectively (RR 2.38, 0.54-10.48). No deaths were directly attributed to the procedure; however, inpatient mortality was higher in the >90 group. Conclusions: ERCP is safe and effective in nonagenarian patients, and advanced age should not be considered an independent risk factor for adverse events nor a contraindication for the procedure.