{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:09:32Z","timestamp":1790172572122,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sedation for conventional endoscopic retrograde cholangiopancreatography (ERCP) has been reported to be safe even for elderly patients. However, the safety of sedation for balloon enteroscopy\u2010assisted ERCP (BE\u2010ERCP) has not been well\u2010studied in the elderly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed consecutive patients with surgically altered anatomy who underwent their initial BE\u2010ERCP using midazolam and pethidine at our institution between January 2016 and December 2022. The primary outcome was the rate of cardiopulmonary complications, including hypotension, bradycardia, tachycardia, and hypoxemia. Secondary outcomes included the rates of procedural interruptions, delayed arousal, postprocedural falls, and delirium, dose of sedatives, and rate of ERCP\u2010related adverse events (AEs). Risk factors for cardiopulmonary complications and ERCP\u2010related AEs were also examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 190 patients were included (elderly group: 63; non\u2010elderly group: 127). After propensity score matching, 55 patients were selected for each group. The total dose of midazolam was significantly lower in the elderly group (4\u00a0mg vs. 5\u00a0mg,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.033). Rates of cardiopulmonary complication (11%\u00a0vs. 11%,\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.999) and ERCP\u2010related AEs (6%\u00a0vs. 9%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.716) were not significantly different between the two groups. The total dose of pethidine (&gt; 35\u00a0mg) and total procedure time (\u2265 51 min) were identified as risk factors for cardiopulmonary complications and ERCP\u2010related AEs, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cardiopulmonary complications and ERCP\u2010related AEs were similar in elderly and non\u2010elderly patients undergoing BE\u2010ERCP. With careful monitoring, sedation during BE\u2010ERCP appeared safe, even for elderly patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70193","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T11:43:24Z","timestamp":1756208604000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse Events of Single Balloon Enteroscopy\u2010assisted Endoscopic Retrograde Cholangiopancreatography in the Elderly: A Propensity Score Matching Analysis"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9077-9289","authenticated-orcid":false,"given":"Hiroki","family":"Nakagawa","sequence":"first","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"},{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Omori Medical Center Toho University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-8166","authenticated-orcid":false,"given":"Tsuyoshi","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7561-5558","authenticated-orcid":false,"given":"Takafumi","family":"Mie","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaaki","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Ozaka","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9244-2820","authenticated-orcid":false,"given":"Takahisa","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Omori Medical Center Toho University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Omori Medical Center Toho University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Sasahira","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12450"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.5282"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31942"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30080524"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i2.764"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13882"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.04.028"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2000.tb02628.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.03.3864"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2013.04.161"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000499"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4064-y"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i37.8382"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/jmas.jmas_325_21"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1255934"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.420"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.13118"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200204000-00031"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.10.027"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2021.11.038"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)90129-5"},{"key":"e_1_2_10_23_1","unstructured":"American Society of Anesthesiologists.ASA Physical Status Classification System. [Internet] [revised] December 13 2020 (original approval: October 15 2014).https:\/\/www.asahq.org\/standards\u2010and\u2010practice\u2010parameters\/statement\u2010on\u2010asa\u2010physical\u2010status\u2010classification\u2010system."},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.04.032"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13414"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i4.463"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3282cf5167"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-018-0897-5"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15019"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.02.013"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1216-1363"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:57:59Z","timestamp":1790171879000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/deo2.70193"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70193","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,26]]},"assertion":[{"value":"2025-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70193"}}