Year 2024 / Volume 116 / Number 5
Editorial
ERCP for common bile duct stones in the elderly: refining the procedure to improve outcomes

241-243

DOI: 10.17235/reed.2024.10352/2024

Jesús García-Cano, Miriam Viñuelas Chicano, Laura Valiente González,

Abstract
Removal of common bile duct stones in patients with a previous cholecystectomy was one of the first indications for ERCP with biliary sphincterotomy. Thanks to a minimally invasive procedure, patients were prevented from having a new operation. Subsequently, as the technique proved to be successful, ERCP was extended to all patients with choledocholithiasis, regardless of whether or not they had gallbladder. Also contributing was the fact that, at least in the beginnings, surgical interventions on the bile duct with laparoscopic cholecystectomy were more difficult. Nowadays, many surgeons prefer to perform cholecystectomy with a bile duct clean of stones. In this issue of the Spanish Journal of Gastroenterology, Gardenyes et al. present a study on ERCP for common bile duct stones in elderly patients. The novelty of this study is not only to analyze the ERCP procedure, which we already knew has similar success and complication rates to younger patients, but also to focus on the long-term outcome, considering the frailty that frequently accompanies aging. The study concludes that older patients may benefit from enhanced care protocols to reduce medical adverse events and improve outcomes. For us gastroenterologists and endoscopists, another conclusion that can be drawn from this study is that we should not be satisfied that ERCP in older patients has the same success and complication rates as in younger patients, but rather we should strive to ensure that the results are even better.
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References
1.Kawai K, Akasaka Y, Murakami K, et al. Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest Endosc 1974; 20: 148-51. doi: 10.1016/s0016-5107(74)73914-1.
2.Siegel JH, Veerappan A, Cohen SA, Kasmin FE. Endoscopic sphincterotomy for biliary pancreatitis: an alternative to cholecystectomy in high-risk patients. Gastrointest Endosc 1994;40: 573-5.
3.Vázquez-Lglesias JL, González-Conde B, López-Rosés L, et al. Endoscopic sphincterotomy for prevention of the recurrence of acute biliary pancreatitis in patients with gallbladder in situ: long-term follow-up of 88 patients. Surg Endosc 2004;18: 1442-6. doi: 10.1007/s00464-003-9185-7.
4.Itoi T, Sofuni A, Itokawa F, et al. Endoscopic transpapillary gallbladder drainage in patients with acute cholecystitis in whom percutaneous transhepatic approach is contraindicated or anatomically impossible (with video). Gastrointest Endosc. 2008; 68: 455-60. doi: 10.1016/j.gie.2008.02.052.
5.Saumoy M, Yang J, Bhatt A, et al. Endoscopic therapies for gallbladder drainage. Gastrointest Endosc. 2021; 94: 671-684. doi: 10.1016/j.gie.2021.05.031.
6.Chhoda A, Mukewar SS, Mahadev S. Managing Gallstone Disease in the Elderly. Clin Geriatr Med. 2021; 37:43-69. doi: 10.1016/j.cger.2020.08.005.
7.García-Cano J, Taberna-Arana L. Advanced age per se should not be a contraindication for ERCP intervention. Gastrointest Endosc. 2006; 64: 296-7. doi: 10.1016/j.gie.2006.03.004.
8.Rodríguez-González FJ, Naranjo-Rodríguez A, Mata-Tapia I, et al. ERCP in patients 90 years of age and older. Gastrointest Endosc. 2003; 58: 220-5. doi: 10.1067/mge.2003.363.
9.Gardenyes J, Roura P, Vallverdú-Cartie H, et al. Endoscopic retrograde cholangiopancreatography for the management of choledocholithiasis in older patients. Rev Esp Enferm Dig 2023. doi: 10.17235/reed.2023.10051/2023. Epub ahead of print.
10.García-Cano J, González Martín JA, Morillas Ariño J, Pérez Sola A. Complications of endoscopic retrograde cholangiopancreatography. A study in a small ERCP unit. Rev Esp Enferm Dig 2004; 96:163-73. doi: 10.4321/s1130-01082004000300002.
11.Akshintala VS, Kanthasamy K, Bhullar FA, et al. Incidence, severity, and mortality of post-ERCP pancreatitis: an updated systematic review and meta-analysis of 145 randomized controlled trials. Gastrointest Endosc 2023; 98: 1-6.e12. doi: 10.1016/j.gie.2023.03.023.
12.Weston BR. Pancreatic steatosis: Identification of yet another "new" modifiable high-risk factor for post-ERCP pancreatitis? Gastrointest Endosc 2024; 99: 224-226. doi: 10.1016/j.gie.2023.10.001.
13.García-Cano J, Viñuelas Chicano M. Should we administer rectal anti-inflammatory drugs in all ERCPs in order to prevent pancreatitis? At least, it does not harm! Rev Esp Enferm Dig 2020;112:167-169. doi: 10.17235/reed.2020.6871/2020.
14.Teles de Campos S, Papaefthymiou A, Florou T, et al. Impact of center and endoscopist ERCP volume on ERCP outcomes: a systematic review and meta-analysis. Gastrointest Endosc 2023; 98: 306-315.e14. doi: 10.1016/j.gie.2023.05.045.
15.Johnston SD, McKenna A, Tham TC. Silent myocardial ischaemia during endoscopic retrograde cholangiopancreatography. Endoscopy 2003; 35: 1039-42. doi: 10.1055/s-2003-44597.
16.García-Cano J. Severe cardiogenic pulmonary edema precipitated by a therapeutic ERCP. Endoscopy 2004; 36: 567. doi: 10.1055/s-2004-814429.
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García-Cano J, Viñuelas Chicano M, Valiente González L. ERCP for common bile duct stones in the elderly: refining the procedure to improve outcomes. 10352/2024


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Publication history

Received: 19/02/2024

Accepted: 24/02/2024

Online First: 12/03/2024

Published: 09/05/2024

Article Online First time: 22 days

Article editing time: 80 days


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