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Meta-Analysis
. 2022 Apr;67(4):1352-1361.
doi: 10.1007/s10620-021-06950-2. Epub 2021 Mar 26.

Safety and Efficacy of Endoscopic Retrograde Cholangiopancreatography in Nonagenarians: A Systematic Review and Meta-Analysis

Umair Iqbal  1 , Hafsa Anwar  2 , Muhammad Ali Khan  3 , Simcha Weissman  4 , Shivangi T Kothari  5 , Truptesh H Kothari  5 , Bradley D Confer  6 , Harshit S Khara  6
Affiliations
Meta-Analysis

Safety and Efficacy of Endoscopic Retrograde Cholangiopancreatography in Nonagenarians: A Systematic Review and Meta-Analysis

Umair Iqbal et al. Dig Dis Sci. 2022 Apr.

Abstract

Background: Recent advances in modern medicine have translated into increase in life expectancy in the USA and with that, a rise in the demand for invasive procedures in elderly patients. Endoscopic retrograde cholangiopancreatography (ERCP) is the procedure of choice for managing various benign and malignant pancreatobiliary conditions and can be associated with various adverse events.

Aim: We performed a systematic review and meta-analysis to evaluate outcomes of ERCP in nonagenarians.

Methods: A comprehensive literature search was performed in Embase, MEDLINE, Web of Science, and Cochrane Review library until July 2020. Our primary outcomes were the rate of technical success and adverse events in nonagenarians. Secondary outcomes were comparison of technical success and adverse events compared with younger patients.

Results: The initial search revealed 4933 studies, of which 24 studies with 5521 patients met our inclusion criteria. Pooled technical success rate of ERCP in nonagenarians was 92%, and pooled adverse event rate was 7.8%. There was no significant difference in technical success rate and overall rate of adverse events comparing ERCP outcomes in nonagenarians with a relatively younger population. The risk of post-ERCP bleeding was significantly higher in nonagenarians compared to younger patients with OR = 1.986 [1.113-3.544], I2 = 0. ERCP-related mortality was also significantly higher in nonagenarians compared to younger patients with OR = 4.720 [1.368-16.289], I2 = 0.

Conclusion: There was no significant difference in technical success rate and risk of adverse events related to ERCP in nonagenarians compared to younger patients. However, the risk of bleeding and procedure-related mortality was significantly higher.

Keywords: ERCP; Meta-analysis; Mortality; Nonagenarians; Post-ERCP adverse events.

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References

    1. Cohen S, Bacon BR, Berlin JA et al. National Institutes of Health State-of-the-Science Conference Statement: ERCP for diagnosis and therapy, January 14–16, 2002. Gastrointest Endosc. 2002;56:803–809 - DOI
    1. Siegel JH, Kasmin FE. Biliary tract diseases in the elderly: management and outcomes. Gut. 1997;41:433–435 - DOI
    1. Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2015. NCHS Data Brief. 2016;267:1–8
    1. Baron TH, Mallery JS, Hirota WK et al. The role of endoscopy in the evaluation and treatment of patients with pancreaticobiliary malignancy. Gastrointest Endosc. 2003;58:643–649 - DOI
    1. Costamagna G, Shah SK, Tringali A. Current management of postoperative complications and benign biliary strictures. Gastrointest Endosc Clin N Am. 2003;13:635–648, ix.

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