{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:33:58Z","timestamp":1790814838834,"version":"4.1.0"},"reference-count":41,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Dis"],"abstract":"<jats:p>Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is the standard treatment for choledocholithiasis. However, elderly patients, particularly those aged \u226580 and \u226590, may face higher risks of complications due to comorbidities and age-related anatomical changes. This meta-analysis aimed to evaluate the efficacy and safety of ERCP in this population. Methods: A systematic search yielded 17 retrospective studies. Data were synthesized using both single-arm and comparative analyses, with subgroup analyses focusing on nonagenarians (\u226590 years). Outcomes assessed included complete stone clearance, cannulation success, adverse events (AEs), sedation strategies, and biliary stent use. Results: The pooled stone clearance rate was 77% in patients \u226580 and 65% in nonagenarians. When multiple ERCP sessions were employed, clearance rates increased to 84% in patients aged \u226580 and 82% in nonagenarians, compared with 61% and 38%, respectively, for single-session procedures. The pooled AEs rate was 8% in patients \u226580 and 6% in those \u226590, with ERCP-related mortality between 0% and 1%. Complete clearance was significantly lower in patients aged \u226580 versus those aged &lt;80 (OR = 0.41; p = 0.003), and in patients aged \u226590 versus those aged &lt;90 (OR = 0.30; p = 0.047), while cannulation success and AEs was similar. Additionally, elderly patients were more likely to receive general anesthesia (OR = 7.08, p &lt; 0.001) and biliary stenting (OR = 2.78; p = 0.002), with permanent stents used more frequently (OR = 15.66, p &lt; 0.001). Nonagenarians experienced higher cardiopulmonary risks (OR = 4.60; p = 0.042). Conclusion: ERCP is effective and safe for elderly patients, though age-related challenges necessitate tailored approaches. Staged procedures and age-adjusted sedation can mitigate risks. While permanent stenting offers palliative utility, long-term monitoring is essential to address late complications.<\/jats:p>","DOI":"10.1159\/000548378","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T16:03:33Z","timestamp":1758297813000},"page":"718-730","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of Therapeutic Endoscopic Retrograde Cholangiopancreatography in Elderly Patients (\u226580 Years) with Choledocholithiasis: A Comprehensive Meta-Analysis"],"prefix":"10.1159","volume":"43","author":[{"given":"Liping","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312317"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.24"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.63115"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-018-0764-4"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.10.001"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1055\/a-0862-0346"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07462-2"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.4174\/astr.2015.88.3.145"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07805-z"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000744"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.2546-18"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.06.051"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2022.020"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2000.107285"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.49.3660"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.5009\/gnl13310"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-108194"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-015-0453-x"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0190665"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12198"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.4103\/jmas.JMAS_162_20"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.6478-20"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.17235\/reed.2023.10051\/2023"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.75246"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2013.10.010"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2010.01100.x"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.03.005"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-023-02976-0"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2006.05.010"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59040795"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2013.46.3.251"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1111\/den.12592"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-009-0784-6"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.04.032"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.09.001"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-826043"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.12.055"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-23632"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5012-9"}],"container-title":["Digestive 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