Efficacy and safety of endoscopic retrograde cholangiopancreatography in the very elderly by using a combination of intravenous midazolam, ketamine and pethidine

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dc.contributor.authorTokmak, Salih
dc.contributor.authorCetin, Mehmet F.
dc.contributor.authorTorun, Serkan
dc.date.accessioned2021-12-01T18:47:03Z
dc.date.available2021-12-01T18:47:03Z
dc.date.issued2021
dc.department[Belirlenecek]en_US
dc.description.abstractAim The number of therapeutic endoscopic procedures in elderly individuals keeps increasing and this population has a high risk of adverse events related to sedation and general anesthesia. However, there is a paucity on data about the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in this population. Methods In total, 417 consecutive ERCP procedures were performed in 362 patients between September 2018 and January 2020. Of these, 59 patients (74 sessions) were aged >= 80 years (Group A) and 173 patients (193 procedures) were aged <= 65 years (Group B). We analyzed the prospectively collected data of patient- and procedure-related variables. Results The procedure time was significantly longer in Group A (P < 0.05). The prevalence of comorbidities, use of anticoagulants and American Society of Anesthesiologists (ASA) physical status classification levels were significantly higher in Group A (P < 0.05). The incidence of periampullary diverticula, malignancy, rate of difficult cannulation, mean number of stones, use of biliary stents and stent dysfunction was also significantly higher in Group A (P < 0.05). The medication doses used were significantly higher and emergence symptoms were significantly more frequent in Group B (P < 0.05). The rates of bleeding, pancreatitis, perforation, cholangitis, hypoxia, hypotension and the length of hospital stay did not significantly differ between the two groups. The overall success rate of the procedure was comparable in the two groups (P = 0.874). Conclusions ERCP can be safely performed in elderly patients using a combination of midazolam and ketamine without propofol. The incidence of complications is comparable with that observed in younger patients. Geriatr Gerontol Int center dot center dot; center dot center dot: center dot center dot-center dot center dot Geriatr Gerontol Int 2021; center dot center dot: center dot center dot-center dot center dot.en_US
dc.identifier.doi10.1111/ggi.14252
dc.identifier.endpage892en_US
dc.identifier.issn1444-1586
dc.identifier.issn1447-0594
dc.identifier.issue10en_US
dc.identifier.pmid34427037en_US
dc.identifier.scopus2-s2.0-85113207943en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage887en_US
dc.identifier.urihttps://doi.org/10.1111/ggi.14252
dc.identifier.urihttps://hdl.handle.net/20.500.12684/10116
dc.identifier.volume21en_US
dc.identifier.wosWOS:000687353300001en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofGeriatrics & Gerontology Internationalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectdeep sedationen_US
dc.subjectelderlyen_US
dc.subjectERCPen_US
dc.subjectpropofolen_US
dc.subjectRandomized Controlled-Trialen_US
dc.subjectEuropean-Societyen_US
dc.subjectAdverse Eventsen_US
dc.subjectErcpen_US
dc.subjectSedationen_US
dc.subjectPropofolen_US
dc.subjectComplicationsen_US
dc.subjectOlderen_US
dc.subjectRisken_US
dc.titleEfficacy and safety of endoscopic retrograde cholangiopancreatography in the very elderly by using a combination of intravenous midazolam, ketamine and pethidineen_US
dc.typeArticleen_US

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