Characteristics of Acute Cholangitis and Endoscopic Management of Elderly Patients at Our Institute

The clinical presentation of acute cholangitis, etiology and complications from endoscopic early biliary drainage in elderly patients was evaluated.

205 patients with acute cholangitis treated at the Kure Medical Center and Chugoku Cancer Center were enrolled. Of these, 108 patients were 75 years old or older (elderly) and 97 patients were younger than 75 years old. Patients’ clinical characteristics, etiology and severity of cholangitis, and complications of endoscopic early biliary drainage were compared between the elderly and younger cohorts.

There was a significant difference in severe cholangitis between elderly and younger patients, at 17.6% and 0%, respectively. There was no significant difference in complications between elderly and younger patients, and between patients with and without early biliary drainage. One 91-year old woman with early biliary drainage had post-ERCP (endoscopic retrograde cholangiopancreatography) aspiration pneumonia and died.

Acute cholangitis in elderly patients may become severe in degree with a high incidence. Early ERCP for elderly persons is relatively safe, but it should be done carefully, not induce a consequent death due to complications such as aspiration pneumonia.

Keywords: Acute cholangitis, Aspiration pneumonia, Biliary drainage, Complications, Elderly patients.