ARE COMPLICATIONS OF ENDOSCOPIC SPHINCTEROTOMY AGE-RELATED

Background-Endoscopic retrograde cholangiopancreatography sphincteroto my is increasingly performed in younger patients undergoing laparoscop ic cholecystectomy. However, the safety of endoscopic sphincterotomy i n this age group, relative to that in older patients, is unknown. Aim- To determine whether the development of short term complications follo wing endoscopic sphincterotomy is age related. Patients and methods-A prospective multicentre audit of 958 patients (mean age 73, range 14-9 7, years) undergoing a total of 1000 endoscopic sphincterotomies. Resu lts-Two deaths occurred, both from postsphincterotomy acute pancreatit is. Postprocedural complications developed in 24 patients: pancreatiti s in 10, ascending cholangitis in seven, bleeding in four, and retrope ritoneal perforation in three. There were six complications (five case s of pancreatitis and one bleed; 2.2%) and no deaths in the 281 (29.3% ) patients aged under 65 years. In comparison, 18 (2.6%) of the 677 pa tients aged over 65 years developed a complication (cholangitis in sev en, pancreatitis in five, bleeding in three, and perforation in three) . Patients under 35, 45, 55, and 65 years were not at significantly in creased risk of complication than those over these ages (relative risk for those under compared with those over 65 years 0.83, 95% confidenc e intervals 0.41-1.67, p=0.74). Conclusion-Short term complications fo llowing endoscopic sphincterotomy are not related to age. Younger pati ents undergoing laparoscopic cholecystectomy need not be denied endosc opic sphincterotomy for fear that the risks are greater than if they u ndergo surgical exploration of the common bile duct.