ERCP in the very elderly: outcomes among patients older than eighty.

Life expectancy is rising, which is increasing the demand for endoscopic retrograde cholangiopancreatography (ERCP) in the elderly. Little data, particularly on complex procedures, has been reported. In this study, we compare the differences in the success and complications in ERCP between patients older and younger than 80 years old. We used a large endoscopic database reviewing the ERCPs performed and 30-day complications addressing age, degree of difficulty of procedures, and complications. A total of 2,606 patients underwent 3,924 ERCPs. Six hundred and twenty-eight were octogenarians undergoing 728 procedures. Mean age was 83.5 years in the octogenarian group and 59.0 years in the younger group. The endoscopic success rate was lower in octogenarians (96.9 vs. 98.3%, P = 0.004). Overall, complication rates between both groups was significantly less in older compared to younger patients (1.64 vs. 3.50%, P = 0.006). Complication and failure rates were higher as procedure complexity increased in all patients. ERCP in the elderly carries a high degree of success with low complication rates. Elderly patients carry similar risks of bleeding and perforation and a lower risk of pancreatitis.

Simultaneous fine-needle aspiration and core biopsy of thyroid nodules and other superficial head and neck masses using sonographic guidance.

OBJECTIVE: The objective of our study was to conceive of and to evaluate a simple system for simultaneous fine-needle aspiration (FNA) and core biopsy of thyroid nodules when FNA alone has failed to yield tissue adequate for diagnosis. CONCLUSION: The use of a modified coaxial guiding needle and biopsy gun is a simple, safe, and effective method for obtaining tissue from thyroid nodules and is applicable to sampling other superficial masses as well.