[Russian consensus on current issues in the diagnosis and treatment of obstructive jaundice syndrome]

[Endoscopic treatment of choledocholithiasis in patients over 80 years old]

OBJECTIVE

To analyze endoscopic treatment of choledocholithiasis in patients over 80 years old.

MATERIAL AND METHODS

A single-center retrospective study included 90 consecutive patients aged ≥80 years and 58 patients aged 60-79 years. Early outcomes including efficacy of calculus removal, incidence of complications and their risk factors were evaluated.

RESULTS

In 75 patients aged ≥80 years (83.3%), endoscopic treatment was effective definitive single procedure. Between-group differences were insignificant (p=0.163). Patients aged ≥80 years were characterized by higher percentage of ASA classes 2-4 (p<0.001), age-adjusted mean Charlson comorbidity index (p=0.004), and ≥2 calculi (64.4% vs. 32.8%, p<0.001). Postoperative morbidity was similar (7.8% vs. 6.9%, p=0.842). Multivariate logistic regression analysis of potential risk factors did not reveal significant correlations: Chi-square test was 14.94 at 15 degrees of freedom (p=0.463).

CONCLUSION

Similar postoperative morbidity determines safety of endoscopic lithoextraction in patients aged over 80 years. We should emphasize higher percentage of advanced age patients with «difficult» choledocholithiasis that requires appropriate training of specialists, adequate equipment of hospitals and routing of patients.