The impact of age on the incidence and severity of post-endoscopic retrograde cholangiopancreatography pancreatitis

Panagiotis Katsinelos; Georgia Lazaraki; Grigoris Chatzimavroudis; Sotiris Terzoudis; Anthi Gatopoulou; Andreas Xanthis; Sotiris Anastasiadis; Kiriaki Anastasiadou; Nikos Georgakis; Dimitris Tzivras; Jannis Kountouras

Authors Panagiotis Katsinelos, Georgia Lazaraki, Grigoris Chatzimavroudis, Sotiris Terzoudis, Anthi Gatopoulou, Andreas Xanthis, Sotiris Anastasiadis, Kiriaki Anastasiadou, Nikos Georgakis, Dimitris Tzivras, Jannis Kountouras.

Abstract

Background With advancing age there is progressive pancreatic atrophy and fibrosis, leading to tissue destruction and chronic pancreatitis that has been found to be protective against postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). However, there are no reports regarding the potential effect of the aging pancreatic changes on the incidence and severity of PEP. Therefore, the aim of the present study was to investigate the impact of senile changes in the pancreas on the incidence and severity of PEP.

Methods A total of 2688 patients who underwent the first therapeutic ERCP at a single center were included in the final analysis of the study. Patients were classified into two groups: 1644 patients aged â‰¤75 years (mean age 61.56+1.26 years), group A; and 1044 patients aged >75 years (mean age 81.97+4.29 years), group B. Patients' files were identified using a retrospective database linked to the endoscopy reporting system. Patients' characteristic, endoscopic findings, details of intervention and rate and severity of PEP were evaluated.

Results No significant differences between the two groups were observed with regard to ERCP indication, patient- and technique-related risk factors for PEP, presence of periampullary diverticulum, and type of therapeutic intervention. The incidence of PEP was 5.2% in group A and 4% in group B (P=NS) with comparable grades of severity. All episodes of pancreatitis had full recovery with conventional treatment. One death occurred from respiratory arrest in each group of patients.

Conclusion This study shows that the pancreatic changes associated with aging do not influence the incidence and severity of PEP.

Keywords Endoscopic retrograde cholangiopancreatography, post-ERCP pancreatitis, age, elderly

Ann Gastroenterol 2018; 31 (1): 96-101