Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2020
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
_version_ 1783576262103531520
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
work_keys_str_mv AT hakutaryunosuke feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT kogurehirofumi feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT nakaiyousuke feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT hamadatsuyoshi feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT satotatsuya feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT suzukiyukari feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT inokumaakiyuki feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT kanaisachiko feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT nakamuratomoka feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT noguchikensaku feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT ishigakikazunaga feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT saitokei feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT saitotomotaka feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT takaharanaminatsu feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT mizunosuguru feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT yamadaatsuo feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT tadaminoru feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly
AT koikekazuhiko feasibilityofballoonendoscopeassistedendoscopicretrogradecholangiopancreatographyfortheelderly