Endoscopic treatment for common bile duct stones in elderly patients aged 90 years or older

Abstract

We investigated 49 cases of common bile duct stones in elderly patients aged 90 years or older. The male-to-female ratio was 17 : 32, with a median age of 92.5 years and the oldest patient aged 99 years. The success rate of initial bile duct intubation in 34 naive papillae was 85.3%. A total of 51 papillary interventions (23 EPLBD, 22 EST, etc.), 53 stone treatments, and 16 EBS were performed. The complete stone removal rate was 77.6%, with EBS accounting for 12.2%. The complication rate was 27.8%, with two fatalities. Five patients with physical limitations were positioned laterally due to difficulty in the prone position. Elderly patients often have diverse medical backgrounds, leading to potential unexpected complications and serious outcomes. Furthermore, as there is no established treatment strategy for asymptomatic bile duct stones, a careful, case-specific approach is essential, along with sufficient informed consent.