Thai Journal of Gastroenterology

Article :
Results and Complications of ERCP in Older Asians with Obstructive Jaundice

Author :
Wiriyaporn Ridtitid, M.D.
Pradermchai Kongkam, M.D.
Pinit Kulavanijaya, M.B. Ch.B., F.A.C.G.
Rungsun Rerknimitr, M.D.

Abstract :

Background: Obstructive jaundice is one of the difficult diagnostic problems in patients with advanced
age. Traditionally, surgery carries a high rate of complications. Lately, ERCP has been accepted as a less invasive treatment for obstructive jaundice

Objectives: To review ERCP findings, results and complications in elderly patients with obstructive jaundice.

Patients and Methods: ERCP database of patients, 70 years of age or older with obstructive jaundice
at The King Chulalongkorn Memorial hospital from January 2003 to October 2005 were analyzed retrospectively.

Results: Fifty-nine patients (33 men and 26 women) with obstructive jaundice underwent ERCP. One
patient had a previous failed ERCP outside The King Chulalongkorn Memorial hospital.  Fifty-two patients (88%) received conscious sedation (midazolam/meperidine) for their procedures.  Therapeutic duodenoscope (Olympus TJF 160, Tokyo, Japan) was used in 81% of the procedures.  The most common finding from routine upper endoscpy was periampullary diverticulum (34%).  Cholangiographic diagnoses included; malignant biliary stricture (44%), choledocholithiasis (17%), benign stricture (3%) and miscellaneous (36%).  Therapeutic procedures were performed in 98% of diagnosed patients and successful in 95%.  The overall complication rate was 9% of which mainly pancreatitis.  No procedure related mortality occurred.

Conclusions: ERCP is safe and effective in geriatric population with obstructive jaundice.

[Thai J Gastroenterol 2006; 7(3): 114-119]

Keyword :
ERCP, older patients, obstructive jaundice

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