Endoscopic ultrasound in patients over 80 years old

Background: The data on the safety and utility of EUS in patients over 80 years of age is limited. Objective: We investigated the indications, feasibility, safety, and clinical utility of EUS in the management of GI, pancreatobiliary, and mediastinal diseases. Design: Retrospective study. Setting: A tertiary referral university hospital. Patients: Consecutive patients ≥80 years of age referred over a 9-year period for EUS evaluation. Results: A total of 265 EUS scans were performed in 232 patients with a mean age of 83.8 years. The indications for pancreatobiliary EUS were to evaluate a pancreatic mass (n = 60), pancreatic cyst (n = 18), pancreatitis (n = 10), dilated CBD in the setting of jaundice and/or biliary stricture (n = 20), dilated CBD with no jaundice and/or biliary stricture (n = 20). The indications for luminal gastrointestinal EUS were esophageal lesions (n = 21), gastric lesions (n = 30), duodenal lesions (n = 14), rectal lesions (n = 22), and gastrointestinal subepithelial lesions (n = 28). The indications for mediastinal EUS were mass/lymphadenopathy (n = 14). EUS-guided FNA (EUS-FNA) was performed in 95 (35.8%) cases and results were consistent or suspicious for a malignancy in 62 cases (65.2%). Endoscopic mucosal resection (EMR) was performed in 17 cases (6.41%) on the same session following endosonographic evaluation. The procedure was successful in all patients with no complications related to sedation, EUS, or EUS-FNA encountered. One patient had perforation following EMR. Limitation: Retrospective study. Conclusions: EUS and EUS-FNA are feasible and safe and have a significant impact on the management of GI, pancreatobiliary and mediastinal diseases in extreme elderly.