Abstract:
BACKGROUND:Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable therapeutic technique for pancreatobiliary diseases, and its application in the elderly is no longer limited. However, a higher incidence of procedure difficulty and periprocedural adverse events might be expected in elderly patients due to the presence of other medical disorders and the poor general condition of this population. AIM:To evaluate the incidence, causes, and management of difficult biliary cannulation during ERCP in elderly patients and the role of difficult cannulation as a risk factor for adverse events. METHODS:A total of 614 patients who underwent ERCP during the study period were prospectively studied and divided into two groups based on their age. One hundred and forty-six patients were aged 80 years or older and 468 patients were aged less than 80 years. The primary outcome measurements were cannulation difficulty, cannulation success rate, ERCP procedure time, and related adverse events. RESULTS:There was no difference in the incidence of difficult cannulation among the two groups (32.9% vs 34.4%, P = 0.765), as well as in the cannulation success rate (96.6% vs 96.8%, P = 0.54). The cannulation techniques were shown to be safe and efficient in achieving successful cannulation. Logistic regression analysis showed that patients aged 80 years or older were not associated with increased adverse events; however, difficult cannulation cases [adjusted odds ratio (AOR) = 3.478; 95% confidence interval (CI): 1.877-6.442; P < 0.001] and patients with Charlson Comorbidity Index ≥ 2 (AOR = 1.824; 95%CI: 0.993-3.349; P = 0.045) were more likely to develop adverse events. In contrast, other factors including age ≤ 65 (AOR = 3.460; 95%CI: 1.511-7.922; P = 0.003), female gender (AOR = 2.362; 95%CI=1.089-5.124; P = 0.030), difficult cannulation (AOR = 4.527; 95%CI: 2.078-9.860; P < 0.001), and patients with cholangitis (AOR = 3.261; 95%CI: 1.204-8.832; P = 0.020) were strongly associated with a higher rate of post-ERCP pancreatitis. CONCLUSION:Advanced age has not been proved to be a risk factor for difficult cannulation, and secondary cannulation techniques can be safely and efficaciously utilized in this group. Patients with a Charlson Comorbidity Index ≥ 2 and difficult cannulation are associated with an increased overall adverse events rate, while age ≥ 80 years is not.
journal_name
World J Clin Casesjournal_title
World journal of clinical casesauthors
Tabak F,Wang HS,Li QP,Ge XX,Wang F,Ji GZ,Miao Ldoi
10.12998/wjcc.v8.i14.2988subject
Has Abstractpub_date
2020-07-26 00:00:00pages
2988-2999issue
14issn
2307-8960journal_volume
8pub_type
杂志文章abstract::Coronavirus disease-2019 (COVID-19) has so far caused hundreds of mortalities worldwide. Although respiratory symptoms are the main complication in COVID-19 patients, the disease is also associated with gastrointestinal problems, with diarrhea, nausea, and vomiting being primary COVID-19 symptoms. Thus, cancer and inf...
journal_title:World journal of clinical cases
pub_type: 杂志文章,评审
doi:10.12998/wjcc.v8.i18.3934
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abstract::The processes of lung fibrogenesis and fibrotic healing are common to a number of conditions with different etiologies. The lungs are the only affected organ in some cases, whereas in others, several organ systems are involved. Therapeutic options can be discussed from various perspectives. In this review, we address ...
journal_title:World journal of clinical cases
pub_type: 杂志文章,评审
doi:10.12998/wjcc.v2.i11.668
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abstract::Splenic hamartoma is a rare benign malformation, composed of an anomalous mixture of normal splenic elements, often found incidentally while working up other complaints or at autopsy. A splenic mass was incidentally found while evaluating the effects of a traffic accident in a 63-year-old woman. Abdominal computed tom...
journal_title:World journal of clinical cases
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abstract:BACKGROUND:Implant vagus nerve stimulation is an adjunctive treatment for intractable epilepsy when patients are not suitable for resective surgery. AIM:To identify the safety and efficacy of vagus nerve stimulation in children with intractable epilepsy and analyze the effects on different epilepsy syndromes. METHODS...
journal_title:World journal of clinical cases
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doi:10.12998/wjcc.v8.i23.5918
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abstract:BACKGROUND:Despite high risk of bacterial contamination, yet there are no studies that have evaluated the optimal hang time of blenderized and reconstituted powdered formulas at standard room temperature and high temperature. AIM:To investigate the optimal hang time of both types of formulas at standard room temperatu...
journal_title:World journal of clinical cases
pub_type: 临床试验
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abstract::We report the case of a 56-year-old woman with pancreatic adenocarcinoma (PA) discovered during an episode of febrile jaundice. A computed tomography (CT) scan showed a mass in the head of the pancreas with circumferential infiltration of the superior mesenteric vein (SMV) and dilatation of the biliary and pancreatic ...
journal_title:World journal of clinical cases
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doi:10.12998/wjcc.v6.i8.214
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abstract::Coronavirus disease-2019 (COVID-19) is spreading throughout the world. Chest radiography and computed tomography play an important role in disease diagnosis, differential diagnosis, severity evaluation, prognosis prediction, therapeutic effects assessment and follow-up of patients with COVID-19. In this review, we sum...
journal_title:World journal of clinical cases
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abstract:BACKGROUND:Solitary respiratory papilloma is a rare epithelial tumor that can be categorized into multiple subtypes depending on tumor location, histological presentation and number. The glandular type is the rarest, with only 30 cases available within the field. Hence, information on its identification and treatment i...
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abstract:BACKGROUND:Congenital bronchobiliary fistula is a rare developmental abnormality with an abnormal fistula between the respiratory system and biliary tract. The aim of this report is to analyze and summarize the clinical features and experience of diagnosing and treating congenital bronchobiliary fistula (CBBF) occurrin...
journal_title:World journal of clinical cases
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abstract::Jejunogastric intussusception is a rare long term complication of Billroth II gastrectomy. The case reported here is a 50 year old man with history of a Billroth II gastrectomy and Braun's side-to-side jejunojejunal anastomosis who presented with hematemesis. On abdominal examination, there was a mass in the left ilia...
journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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abstract:AIM:To investigated the association between the tumor cells' expression of E-cadherin and the numbers of several types of inflammatory cells infiltrating into the invasive portion of gallbladder cancer (GBC). METHODS:We analyzed 50 GBC cases for which a sufficient amount of tumor tissues for tissue microarray (TMA) ha...
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journal_title:World journal of clinical cases
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更新日期:2020-10-26 00:00:00
abstract:BACKGROUND:Type A insulin resistance syndrome is a rare disorder caused by mutations in the gene encoding the insulin receptor. Its coexistence with ovarian serous papillary cystadenofibroma is even rarer. CASE SUMMARY:A 14-year-old girl developed type A insulin resistance syndrome and showed high fasting insulin, glu...
journal_title:World journal of clinical cases
pub_type:
doi:10.12998/wjcc.v8.i15.3334
更新日期:2020-08-06 00:00:00
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journal_title:World journal of clinical cases
pub_type: 杂志文章
doi:10.12998/wjcc.v3.i2.204
更新日期:2015-02-16 00:00:00
abstract::The current pandemic of coronavirus disease 2019 (COVID-19) which was first detected in Wuhan, China in December 2019 is caused by the novel coronavirus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The virus has quickly spread to a large number of countries leading to a great number of deaths. U...
journal_title:World journal of clinical cases
pub_type: 杂志文章,评审
doi:10.12998/wjcc.v8.i15.3156
更新日期:2020-08-06 00:00:00
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journal_title:World journal of clinical cases
pub_type:
doi:10.12998/wjcc.v3.i10.915
更新日期:2015-10-16 00:00:00
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journal_title:World journal of clinical cases
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doi:10.12998/wjcc.v8.i16.3601
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journal_title:World journal of clinical cases
pub_type:
doi:10.12998/wjcc.v7.i24.4292
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journal_title:World journal of clinical cases
pub_type: 杂志文章
doi:10.12998/wjcc.v7.i2.130
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journal_title:World journal of clinical cases
pub_type:
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journal_title:World journal of clinical cases
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更新日期:2014-08-16 00:00:00
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journal_title:World journal of clinical cases
pub_type: 杂志文章
doi:10.12998/wjcc.v4.i3.63
更新日期:2016-03-16 00:00:00
abstract:BACKGROUND:Pseudohypoparathyroidism type Ia (PHP Ia) is a rare hereditary syndrome, and patients with early PHP Ia are generally not diagnosed based on the presentation of cutaneous nodules as the main clinical feature. Here, we describe a Chinese boy with PHP Ia in whom the main clinical feature was cutaneous nodules,...
journal_title:World journal of clinical cases
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更新日期:2020-02-06 00:00:00
abstract:BACKGROUND:Inflammatory cytokines play a vital role in the occurrence of osteoarticular injury and inflammation. Whether inflammation-associated factors interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) are involved in the pathogenesis of keen articular cartilag...
journal_title:World journal of clinical cases
pub_type: 杂志文章
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更新日期:2019-06-06 00:00:00
abstract:BACKGROUND:Melanotic Xp11-associated tumors are rare mesenchymal-derived tumors. So far, most primary melanotic Xp11-associated tumors have been reported in the kidney, and reports of this tumor in the gastrointestinal tract are rare. CASE SUMMARY:Here we describe the case of a 25-year-old woman who presented with a m...
journal_title:World journal of clinical cases
pub_type:
doi:10.12998/wjcc.v7.i5.684
更新日期:2019-03-06 00:00:00
abstract::Inflammatory bowel disease (IBD) is a chronic immune-mediated disease that affects the gastrointestinal tract. It is argued that environment, microbiome, and immune-mediated factors interact in a genetically susceptible host to trigger IBD. Recently, there has been increased interest in the development, progression, a...
journal_title:World journal of clinical cases
pub_type: 杂志文章,评审
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更新日期:2021-01-16 00:00:00
abstract:BACKGROUND:Anti-D antibody is not the common cause of Rh-isoimmunization in Chinese neonatal jaundice. Recent change in national population policy has followed by an increase in Rh-isoimmunization related hemolytic disease of the newborn (HDN). Unfortunately, regional status of Rh-HDN is unavailable. We hypothesize tha...
journal_title:World journal of clinical cases
pub_type: 杂志文章
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更新日期:2019-10-26 00:00:00
abstract::Ehlers-Danlos syndrome (EDS) is a group of inherited connective tissue disorders caused by collagen synthesis defects. Several hemostatic abnormalities have been described in EDS patients that increase the bleeding tendencies of these patients. This case report illustrates a patient with an unusual presentation of a p...
journal_title:World journal of clinical cases
pub_type:
doi:10.12998/wjcc.v2.i3.75
更新日期:2014-03-16 00:00:00
abstract::Acute pancreatitis is rarely associated with drugs. Acetaminophen overdose is a well-known cause of hepatic toxicity, but drug-induced pancreatitis is rarely reported, especially after mild overdose. A 32-year-old woman presented with nausea and vomiting for 12 h, but no abdominal pain following an overdose of eight T...
journal_title:World journal of clinical cases
pub_type:
doi:10.12998/wjcc.v6.i9.291
更新日期:2018-09-06 00:00:00