ObjectiveTo summarize and analyze the reasons for the failure of ERCP operation in the elderly, and the efficacy of different treatment options. MethodsWe performed a retrospective analysis of the reasons for failed ERCP and the next treatment in the elderly. ResultsThere are 422 patients with 509 times ERCP operation and 68 times of ERCP operation failure. There were 36 elderly patients with a total of 38 unsuccessful operations.The reasons for the operation failure were inaccessible papilla(31.6%), accessible papilla(50.0%), and surgical postoperative change(18.4%) .In addition to duodenal papillary structure abnormalities, the pyloric stenosis, duodenal stenosis, biliary stricture caused by malignant tumor in patients accounted for 50.0%, 88.9% and 50.0% respectively. After failed ERCP,12 cases (31.57%) selected surgical treatment, 8 patients (21.05%) were got PTCD to temporary relief symptoms, 6 cases (15.80%) choose conservative medical treatment, 7 cases (18.42%) received ERCP again, 3 cases (7.89%) give up treatment;all patients were regularly telephone follow-up (follow-up time was 1 month to 18 months, the median follow-up time was 10 months). At present, 16 patients (44.44%) died , except one patient died of septic shock due to choledocholithiasis , the rest are malignant tumors. ConclusionThe causes of the failure of the elderly and young people are the same when perform ERCP. In addition to the abnormal structure of the duodenal papilla, malignant tumor disease is an important reason for the failure of ERCP in the elderly.

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