Objective: To investigate the effect of age on the occurrence of complicating pancreatitis (PEP) and its severity after endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct stones.
Methods: The clinical data of 512 patients with common bile duct stones undergoing ERCP from September 2014 to April 2018 were retrospectively analyzed. Of the patients, 232 cases with age equal to or over 75 years were defined as observation group, and 280 cases with age below 75 years were served as control group. The main clinical variables and the incidence as well as the severity of PEP were compared between the two groups of patients.
Results: In observation group, except the proportions of cases with concomitant geriatric conditions (hypertension, diabetes and coronary heart disease) were higher than those in control group (all P<0.05), all other general data showed no significant differences with control group (all P>0.05). There were no significant differences in terms of treatment success rate of ERCP, intraoperative variables and treatment procedures between the two groups of patients (all P>0.05). The incidence rates of postoperative bleeding and hyperamylasemia showed no significant differences between the two groups of patients (both P>0.05). In the entire group, the incidence rate of PEP was 10.94% (56/512), which in observation group was 6.47% (17/232), including 4.74% (11/232) mild, 2.16% (5/232) moderate and 0.43% (1/232) severe PEP; in control group it was 13.93% (39/280), including 8.93% (25/280) mild, 4.29% (12/280) moderate and 0.71% (2/280) severe PEP. The overall incidence rate of PEP in observation group was significantly lower than that in control group (P=0.017), and the incidence rate of each degree of PEP was lower than in control group, but all did not reach a significant difference (P=0.065, 0.180, 0.676). All complications in both groups of patients were alleviated after aggressive conservative treatment.
Conclusion: Atrophy, fibrosis and exocrine hypofunction of the pancreas result from increase in age have a certain inhibitory effect on the occurrence of PEP, but have no obvious influence on the severity of PEP. However, this result still needs to be further assessed by big data from multiple centers.