Abstract
Given the rapidly aging society in Japan, the number of elderly patients requiring endoscopic treatments for choledocholithiasis has steadily increased. In this comparative study, we investigated the clinical characteristics and outcomes of two groups of patients who underwent endoscopic treatments for choledocholithiasis, those≥90 years old (n=53) and those<90 years old (n=917), in efforts to determine the most effective management of the most elderly group. There were no significant differences in the number of treatment sessions between the two groups. However, the group≥90 years old had a significantly lower rate of complete stone removal and significantly shorter period of hospitalization. There were no significant differences in the postoperative complications related to the endoscopic retrograde cholangiopancreatography procedure. Although we found that endoscopic treatments for elderly patients with choledocholithiasis were effective with satisfactory outcomes, postoperative management of elderly patients must be meticulous in order to prevent serious postoperative complications as they frequently have coexisting cardiopulmonary and/or cerebrovascular diseases. Optimal preoperative preparation, management of the underlying disease, proficiency in endoscopy, and early detection and immediate treatment of complications are all important factors for performing endoscopic treatments safely and effectively in elderly patients over 90 years of age.
