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ERCP başarısı ve komplikasyonlarının yaşa göre değerlendirilmesi

Giriş ve Amaç: Endoskopik retrograd kolanjiopankreatografi diğer gastrointestinal endoskopik yöntemlere göre daha yüksek komplikasyon oranına sahiptir. Özellikle komplikasyon geliştiğinde, yaşlı hastaların operasyonlar sonrası düzelmesi gençlere göre daha zor olmaktadır. Bu çalışmada amacımız çeşitli yaş gruplarında yapılan endoskopik retrograd kolanjiopankreatografi işlemlerinin değerlendirilmesi ve yaşlı hastalarda işlem başarısı ve güvenilirliğinin değerlendirilmesidir. Gereç ve Yöntem: Kliniğimizde Ocak 2018-Haziran 2018 tarihleri arasında yapılan 301 hastaya ait endoskopik retrograd kolanjiopankreatografi işlemleri retrospektif olarak değerlendirildi. Hastalar yaşlarına göre 60 yaş altı, 60-80 yaş arası ve 80 yaş üstü olarak 3 gruba ayrıldı. Her grupta işlem başarısı, komplikasyonlar, işlem tekrarı gerekliliği, işlem endikasyonları değerlendirildi ve gruplar birbiriyle karşılaştırıldı. Bulgular: Hastaların 163’ü (%54.2) kadın ve 138’i (%45.8) erkekti. Tüm hasta gruplarında en sık endoskopik retrograd kolanjiopankreatografi endikasyonu safra taşıydı. İşlem başarısı, işlem tekrarı gerekliliği, pre-cut kesi gerekliği açısından gruplar arası fark saptanmadı. Grup 2 ve 3’de endoskopik retrograd kolanjiopankreatografi endikasyonları benzer iken Grup 1’de Grup 2 ve Grup 3’e göre benign nedenler anlamlı olarak daha fazla saptandı. Komplikasyonlar değerlendirildiğinde gruplar arasında istatiktiksel olarak anlamlı fark saptanmadı (p=0.837). Hastaların hiçbirinde perforasyon, kanama ya da ölüm görülmedi. Sonuç: Çalışmamızda endoskopik retrograd kolanjiopankreatografi başarısı, işlem tekrarı gerekliliği ve komplikasyonları tüm yaş gruplarında benzer saptadık. Çalışmamız ve literatür eşliğinde yaşlılarda endoskopik retrograd kolanjiopankreatografi işleminin gençler ile benzer etkinlik ve güvenlikte olduğunu düşünmekteyiz.

Anahtar Kelimeler:

Endoskopik retrograd kolanjiyopankreatografi, post- endoskopik retrograd kolanjiopankreatografi, komplikasyonlar, yaşlı hastalar

Evaluation of endoscopic retrograde cholangiopancreatography success and complications according to age

Background and Aims: Endoscopic retrograde cholangiopancreatography has a higher complication rate than other gastrointestinal endoscopic methods. It is more difficult for elderly patients than for younger patients to recover after surgery, especially when complications occur. This study aimed to evaluate the endoscopic retrograde cholangiopancreatography procedures performed in various age groups and their success and safety in elderly patients. Material and Methods: Endoscopic retrograde cholangiopancreatography procedures performed in 301 patients in our clinic between January 2018 and June 2018 were retrospectively evaluated. The patients were divided into 3 groups according to their age, i.e., <60 years, between 60 and 80 years, and >80 years[Editor1]. Procedure success, complications, necessity of reprocedure, and indications were evaluated in each group and the results were compared among the groups. Results: A total of 163 (54.2%) of the patients were women and 138 (45.8%) were men. The most common indication for endoscopic retrograde cholangiopancreatography was bile duct[Editor2] in all patient groups. There was no difference among the groups in terms of procedure success, necessity of reprocedure, and pre-cut incision. While the indications for endoscopic retrograde cholangiopancreatography were similar in groups 2 and 3, benign causes were significantly higher in group 1 than in both groups 2 and 3. There was no statistically significant difference among the groups in terms of complications (p = 0.837). None of these patients experienced perforation, bleeding, or death. Discussion: We found that endoscopic retrograde cholangiopancreatography success, necessity of reprocedure, and complications were similar among the groups. We conclude that endoscopic retrograde cholangiopancreatography procedure has similar efficacy and safety in elderly patients and younger patients.

Keywords:

Endoscopic retrograde cholangiopancreatography, post-ERCP complications,

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