To investigate the clinical characteristics of ultra-elderly patients with biliary pancreatic periampullary disease treated with endoscopic retrograde cholangiopancreatography (ERCP).

The clinical data of three hundred and seven patients with ERCP treated in the Affiliated Hospital of North Sichuan Medical College were analyzed retrospectively. According to the age, the patients were divided into the ultra-elderly group (aged over 80 years) and the control group (aged under 80 years), and the clinical characteristics were explored.

The average age of 92 patients in the ultra-elderly group was (85.29±7.32) years, and that of 215 patients in the control group was (57.81±14.26) years. The primary disease of the ultra-elderly group was ampullary cancer (P<0.01). The proportions of ASA grade Ⅲ and Ⅳ, hypertension, coronary heart disease, diabetes mellitus, chronic obstructive pulmonary disease and duodenal diverticulum in the ultra-elderly group were significantly higher than that in the control group (P<0.05). The proportion of patients with malignant biliary stricture and stent implantation or replacement in the ultra-elderly group was significantly higher (P=0.023, <0.001), while the proportion of patients with choledocholithiasis was lower (P=0.005), and the incidence of postoperative bleeding was significantly higher (P=0.021). Univariate analysis showed that malignant obstructive jaundice as the primary disease (P=0.044), accompanied by duodenal diverticulum (P<0.001), hypertension (P=0.022) and coronary heart disease (P=0.012), endoscopic sphincterotomy for treatment of duodenal papillae (P=0.012) were risk factors for postoperative bleeding after ERCP.

Periampullary malignant diseases of gallbladder, pancreas and ampulla have a high incidence in the ultra-elderly patients with many complications, but they are not absolute contraindication of therapeutic ERCP. The risk of bleeding after operation should be prevented clinically.