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Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly
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 uncommo...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
© Georg Thieme Verlag KG
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458759/ https://www.ncbi.nlm.nih.gov/pubmed/32904855 http://dx.doi.org/10.1055/a-1216-1363 |
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author | Hakuta, Ryunosuke Kogure, Hirofumi Nakai, Yousuke Hamada, Tsuyoshi Sato, Tatsuya Suzuki, Yukari Inokuma, Akiyuki Kanai, Sachiko Nakamura, Tomoka Noguchi, Kensaku Ishigaki, Kazunaga Saito, Kei Saito, Tomotaka Takahara, Naminatsu Mizuno, Suguru Yamada, Atsuo Tada, Minoru Koike, Kazuhiko |
author_facet | Hakuta, Ryunosuke Kogure, Hirofumi Nakai, Yousuke Hamada, Tsuyoshi Sato, Tatsuya Suzuki, Yukari Inokuma, Akiyuki Kanai, Sachiko Nakamura, Tomoka Noguchi, Kensaku Ishigaki, Kazunaga Saito, Kei Saito, Tomotaka Takahara, Naminatsu Mizuno, Suguru Yamada, Atsuo Tada, Minoru Koike, Kazuhiko |
author_sort | Hakuta, Ryunosuke |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7458759 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | © Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-74587592020-09-03 Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly Hakuta, Ryunosuke Kogure, Hirofumi Nakai, Yousuke Hamada, Tsuyoshi Sato, Tatsuya Suzuki, Yukari Inokuma, Akiyuki Kanai, Sachiko Nakamura, Tomoka Noguchi, Kensaku Ishigaki, Kazunaga Saito, Kei Saito, Tomotaka Takahara, Naminatsu Mizuno, Suguru Yamada, Atsuo Tada, Minoru Koike, Kazuhiko Endosc Int Open 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. © Georg Thieme Verlag KG 2020-09 2020-08-31 /pmc/articles/PMC7458759/ /pubmed/32904855 http://dx.doi.org/10.1055/a-1216-1363 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Hakuta, Ryunosuke Kogure, Hirofumi Nakai, Yousuke Hamada, Tsuyoshi Sato, Tatsuya Suzuki, Yukari Inokuma, Akiyuki Kanai, Sachiko Nakamura, Tomoka Noguchi, Kensaku Ishigaki, Kazunaga Saito, Kei Saito, Tomotaka Takahara, Naminatsu Mizuno, Suguru Yamada, Atsuo Tada, Minoru Koike, Kazuhiko Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly |
title | Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly |
title_full | Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly |
title_fullStr | Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly |
title_full_unstemmed | Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly |
title_short | Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly |
title_sort | feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458759/ https://www.ncbi.nlm.nih.gov/pubmed/32904855 http://dx.doi.org/10.1055/a-1216-1363 |
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