İki Yaşlı Hasta Grubunda ERCP Sonuçlarının Karşılaştırmalı Analizi: Yaşlı ve Süper Yaşlı Hastalar

Abstract

Amaçlar: Endoskopistler, genellikle süper yaşlı (85 yaş ve üzeri) hastalarda ERCP yapmaktan kaçınmaktadır. Bunun nedeni, bu hastaların sıklıkla komorbiditelere sahip olması ve fizyolojik rezervlerinin azalmasıdır. Bu çalışmanın amacı, 85 yaş üstü süper yaşlı popülasyonda ERCP'nin etkinliğini ve güvenliğini değerlendirmektir. Gereç ve Yöntemler: Bu retrospektif çalışma, üçüncü basamak bir sağlık merkezinde gerçekleştirildi. Şubat 2019 ile Haziran 2022 tarihleri arasında naive papillae ile ERCP uygulanan 75 yaş ve üstü hastalar çalışmaya dahil edildi. Hastalar, süper yaşlı (≥85 yaş) ve yaşlı (75–84 yaş) olarak sınıflandırıldı. Gruplar arasında işlem verileri, etkinlik ve ERCP’ye bağlı advers olaylar karşılaştırıldı. Bulgular: Çalışmaya toplam 260 hasta dahil edildi: 200’ü (%76,9) yaşlı, 60’ı (%23,1) süper yaşlı grubunda yer aldı; bu gruptaki 37 hasta 90 yaşın üzerindeydi. Süper yaşlı grubunda yaş ve Charlson skoru anlamlı derecede daha yüksekti (p<0,001). İşlemsel başarı, kanülasyon süresi, zor kanülasyon oranları ve kullanılan teknikler açısından gruplar arasında anlamlı bir fark yoktu. Ancak, süper yaşlı grupta kardiyopulmoner komplikasyonlar daha sık görüldü (%8,3 vs. %2, p=0,033) ve bu hastaların hastanede kalış süreleri daha uzundu (p=0,005). Sonuç: ERCP, süper yaşlı hastalar için güvenli ve etkili bir prosedür olarak görülmüştür ve yaş grupları arasında ERCP’ye bağlı advers olaylar açısından anlamlı bir fark bulunmamıştır. Bununla birlikte, süper yaşlı hastalarda kardiyopulmoner komplikasyon riskinin artması, dikkatli bir ön değerlendirme ve yönetim gerektirmektedir.

Keywords

• ERCP
• Pankreatit
• Olumsuz olaylar

Comparative Analysis of ERCP Results in Two Elderly Cohorts: Late Elderly and Super-Aged Patients

Abstract

Aims: Endoscopists may generally avoid performing ERCP in super-old patients. This is because these patients often have comorbid conditions and reduced physiological function. The aim of this study was to evaluate the efficacy and safety of ERCP in the super-old population over 85 years of age. Materials and Methods: This study was retrospectively designed in a single tertiary care centre. Patients over 75 years of age with naive papillae who underwent ERCP between February 2019 and June 2022 were included in the study. Among the patients in the study, patients over 85 years of age were defined as süper-old, and patients aged 75-84 years were defined as old. The procedural data, efficacy and procedure-related adverse events of ERCP were compared between the two groups. Results: A total of 260 patients were included, with 200 (76.9%) in the old group and 60 (23.1%) in the super-old group, of whom 37 were over 90 years old. According to the results of the analyses, only age and Charlson score showed a significant difference (p<0.001) between the demographic variables. There was no significant difference between the two groups in terms of procedural success, cannulation time, difficult cannulation, cannulation techniques and other procedural data. Cardiopulmonary complications were significantly more frequent in the super-old group (8.3% versus 2%, p=0.033). The length of hospital stay was also found to be higher in the super-old group compared to the old group (p=0.005). Conclusion: Our study demonstrated that ERCP is a safe and effective procedure in super-old patients, with no significant difference in ERCP related adverse events between elderly groups. However, cardiopulmonary complications warrant caution and may lead to longer, more complex hospitalizations for super-aged patients undergoing ERCP.

Keywords

• adverse events
• ERCP
• pancreatitis

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