Endoscopy 2021; 53(S 01): S79-S80
DOI: 10.1055/s-0041-1724449
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Saturday, 27 March 2021 12:00 – 12:45 Difficult bile stones in year 2021 Room 5

Advanced Age: A Predictor Of Difficut Lithiasis During ERCP?

A Nakhli
1   Faculté de Médecine de Tunis, Gastroenterologie, Habib Thameur Hospital, Tunis, Tunisia
,
M Sabbah
1   Faculté de Médecine de Tunis, Gastroenterologie, Habib Thameur Hospital, Tunis, Tunisia
,
D Trad
1   Faculté de Médecine de Tunis, Gastroenterologie, Habib Thameur Hospital, Tunis, Tunisia
,
N Bellil
1   Faculté de Médecine de Tunis, Gastroenterologie, Habib Thameur Hospital, Tunis, Tunisia
,
A Ouakaa
1   Faculté de Médecine de Tunis, Gastroenterologie, Habib Thameur Hospital, Tunis, Tunisia
,
H Elloumi
1   Faculté de Médecine de Tunis, Gastroenterologie, Habib Thameur Hospital, Tunis, Tunisia
,
N Bibani
1   Faculté de Médecine de Tunis, Gastroenterologie, Habib Thameur Hospital, Tunis, Tunisia
,
D Gargouri
1   Faculté de Médecine de Tunis, Gastroenterologie, Habib Thameur Hospital, Tunis, Tunisia
› Author Affiliations
 
 

    Aims Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and stone extraction using a Dormia balloon or a basket is the standard treatment for common bile duct (CBD) stones. When the clearance of the CBD cannot be obtained by standard techniques, it is referred to as difficult lithiasis. Advanced age is one of the causes of difficult lithiasis (1,2). The objective of this study was to identify parameters that could explain the higher failure rate in older age.

    Methods This is a retrospective study that included all patients who had ERCP for common bile duct stones between January 2014 and December 2017. The patients were divided into two groups:

    group 1: patients aged> 65 years and

    group 2: patients aged ≤ 65 years. Epidemiological, clinical, para-clinical and endoscopic data were compared between the two groups. The statistical study was carried out with SPSS software (p significant if <0.05).

    Results We included 182 patients who were divided into: group 1 (n = 86) andgroup 2 (n = 95). The main characteristics of the two groups are summarized in the table below:

    Tab. 1

    Characteristics

    G 1 > 65 years

    (n = 86)

    G 2 ≤ 65 years

    (n = 95)

    p

    Epidemiology

    • Sex [M/W]

    26/60

    22/58

    0,698

    • Cholecystectomy

    70 %

    65 %

    0,512

    Indications

    • Residual lithiasis

    70 %

    65 %

    0,512

    • Sequential treatement

    10 %

    21 %

    0,055

    • Clearance of CBD stones without gallbladder removal

    20 %

    14 %

    0,301

    Biology

    • ASAT (ULN)

    2 (1-8)

    2,8 (1-14)

    0,244

    • ALAT (ULN)

    2,2 (1-15)

    3,5 (1-12)

    0,090

    • Bilirubin (µmol/l)

    39,9 (2-133)

    59,5 (3-282)

    0,170

    • Hb (g/dl)

    12,5 (8-16)

    12,9 (9,5-16,8)

    0,305

    • PT (%)

    91,5

    89,4 %

    0,402

    Endoscopy

    • Small papilla

    31 %

    29,5 %

    0.839

    • Eccentric papilla

    3,5 %

    2,6 %

    0,731

    • Intra-diverticular papilla

    7,1 %

    2,6 %

    0,185

    • Para-diverticular papilla

    22,4 %

    6,4 %

    0.004

    • Papilla hidden by a fold

    1,2 %

    1,3 %

    0.951

    • Diameter of the CBD (mm)

    15,6 (7-30)

    12,45 (7-30)

    <10-3

    • Stone size (mm)

    12,36 (5-25)

    13,7 (9,5-16,8)

    0,539

    • Average stones number

    1,8

    1,2

    0,026

    • >3 stones

    17,4 %

    8,8 %

    0.134

    • Stenosis of the CBD

    4 %

    2,9 %

    0.731

    • Impacted stone

    6,7 %

    0

    0.030

    • Clearance of the CBD

    54,7 %

    70 %

    0.042

    ALAT: Alanine amino-transférase

    ASAT: Aspartate amino-transférase

    CBD: common bile duct

    Hb: Hémoglobin

    ULN: upper limit of normal

    PT: prothrombin time

    Conclusions In our series, the failure rate of ERCP was higher in the elderly. This could be explained by the higher frequencies of para-diverticular papilla and impacted stones, a larger diameter of the CBD and a higher average number of stones.

    Citation: Nakhli A, Sabbah M, Trad D et al. OP192 ADVANCED AGE: A PREDICTOR OF DIFFICUT LITHIASIS DURING ERCP?. Endoscopy 2021; 53: S79.


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    Publication History

    Article published online:
    19 March 2021

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