Wang L, Li ZY, Wu F, Tan GQ, Wang BL. Endoscopic retrograde cholangiopancreatography for patients aged ninety and older with choledocholithiasis: A single-center experience in south China. World J Gastrointest Endosc 2025; 17(1): 102010 [DOI: 10.4253/wjge.v17.i1.102010]
Corresponding Author of This Article
Fan Wu, MD, Department of Hepatobiliary Surgery, Guangzhou Red Cross Hospital of Jinan University, No. 396 Tongfu Road, Guangzhou 510220, Guangdong Province, China. wufan7911@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jan 16, 2025; 17(1): 102010 Published online Jan 16, 2025. doi: 10.4253/wjge.v17.i1.102010
Endoscopic retrograde cholangiopancreatography for patients aged ninety and older with choledocholithiasis: A single-center experience in south China
Lei Wang, Zi-Ye Li, Fan Wu, Guo-Qian Tan, Bai-Lin Wang
Lei Wang, Zi-Ye Li, Fan Wu, Guo-Qian Tan, Bai-Lin Wang, Department of Hepatobiliary Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510220, Guangdong Province, China
Author contributions: Wang L and Li ZY performed data collection and manuscript drafting; Wu F, Tan GQ, and Wang BL planned and designed the study; Wu F revised the manuscript for important intellectual content; and all authors issued final approval for the version to be submitted.
Supported by the Natural Science Foundation of China, No. 81974442; and Science and Technology Project of Guangzhou City, No. 2024A03J0670.
Institutional review board statement: The study was reviewed and approved by the ethics committee of Guangzhou Red Cross Hospital of Jinan University Institutional Review Board (approval No. 2024-249-01).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fan Wu, MD, Department of Hepatobiliary Surgery, Guangzhou Red Cross Hospital of Jinan University, No. 396 Tongfu Road, Guangzhou 510220, Guangdong Province, China. wufan7911@163.com
Received: October 8, 2024 Revised: November 25, 2024 Accepted: December 27, 2024 Published online: January 16, 2025 Processing time: 102 Days and 4 Hours
Abstract
BACKGROUND
Endoscopic retrograde cholangiopancreatography (ERCP) serves an essential role in treating biliary diseases, especially in choledocholithiasis. However, due to the limited human lifespan, there remains a paucity of clinical investigations on ERCP treatment in patients over 90 years old.
AIM
To explore the effectiveness and safety of ERCP in super-older patients aged ≥ 90 years with choledochal stones.
METHODS
This study retrospectively analyzed data from patients (aged ≥ 65 years) with choledocholithiasis who received ERCP treatment in our hospital from 2011 to 2023. Among them, patients ≥ 90 years old were in the super-older group, and patients aged 65-89 years were in the older group. Baseline data, including gender, number of stones, stone size, gallbladder stones, periampullary diverticulum, and common bile duct intubation of patients in the two groups, were matched by adopting the 1:1 propensity score matching method.
RESULTS
After matching, 44 patients were included in both the super-older group and the older group. The incidence of stroke in the super-older group was markedly higher than that in the older group [34.1% (15/44) vs 6.8% (3/44), P = 0.008]. The success rate of the ERCP procedure in the super-older group was 90.9% (40/44), compared to that in the older group [93.2% (41/44), P = 1.000]. Although endoscopic papillary balloon dilation was more frequently used in the super-older group than in the older group [61.4% (27/44) vs 18.2% (8/44), P < 0.001], there was no significant difference in terms of stone removal rate, the incidence of complications, mortality, recurrence, and length of hospitalization between the two groups (P > 0.05).
CONCLUSION
ERCP is safe and effective in super-older patients ≥ 90 years old with choledocholithiasis.
Core Tip: For the number of super-older patients with choledocholithiasis is small, only a few studies have investigated the therapeutic effects of endoscopic retrograde cholangiopancreatography (ERCP) in such patients, which is insufficient in this rapidly aging world. The aim of this study was to compare the safety and efficacy of ERCP in patients aged 90 and older with patients aged 65-89 years by using a propensity score matching method to reduce bias. After matching, 44 patients were included in each group and our results showed no significant difference in the rates of successful ERCP procedures or complications between the two groups.
