PMID- 32904855
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 9
DP  - 2020 Sep
TI  - Feasibility of balloon endoscope-assisted endoscopic retrograde 
      cholangiopancreatography for the elderly.
PG  - E1202-E1211
LID - 10.1055/a-1216-1363 [doi]
AB  - 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.
FAU - Hakuta, Ryunosuke
AU  - Hakuta R
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Kogure, Hirofumi
AU  - Kogure H
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
AD  - Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, Tokyo, 
      Japan.
FAU - Nakai, Yousuke
AU  - Nakai Y
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
AD  - Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, Tokyo, 
      Japan.
FAU - Hamada, Tsuyoshi
AU  - Hamada T
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Sato, Tatsuya
AU  - Sato T
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Suzuki, Yukari
AU  - Suzuki Y
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Inokuma, Akiyuki
AU  - Inokuma A
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Kanai, Sachiko
AU  - Kanai S
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Nakamura, Tomoka
AU  - Nakamura T
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Noguchi, Kensaku
AU  - Noguchi K
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Ishigaki, Kazunaga
AU  - Ishigaki K
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Saito, Kei
AU  - Saito K
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Saito, Tomotaka
AU  - Saito T
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Takahara, Naminatsu
AU  - Takahara N
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Mizuno, Suguru
AU  - Mizuno S
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Yamada, Atsuo
AU  - Yamada A
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Tada, Minoru
AU  - Tada M
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Koike, Kazuhiko
AU  - Koike K
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200831
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7458759
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2020/09/10 06:00
MHDA- 2020/09/10 06:01
PMCR- 2020/09/01
CRDT- 2020/09/09 18:08
PHST- 2020/02/29 00:00 [received]
PHST- 2020/07/02 00:00 [accepted]
PHST- 2020/09/09 18:08 [entrez]
PHST- 2020/09/10 06:00 [pubmed]
PHST- 2020/09/10 06:01 [medline]
PHST- 2020/09/01 00:00 [pmc-release]
AID - 10.1055/a-1216-1363 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Sep;8(9):E1202-E1211. doi: 10.1055/a-1216-1363. Epub 2020 
      Aug 31.