Endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II anastomosis is challenging due to post-surgical anatomical alterations. This study aims to compare the clinical outcomes of using a duodenoscope and a cap-assisted gastroscope in these patients. Seventy-nine patients with Billroth II anastomosis and a naïve papilla were included in the study. ERCP was performed using either a cap-assisted gastroscope (n = 45) or a duodenoscope (n = 34). The primary outcome was the cannulation success rates, while secondary outcomes included clinical success rates, cannulation time, procedure duration, and complications. Afferent limb intubation was successful in 67.1% of patients. Among these, selective biliary cannulation (SBC) was achieved in 73.6%, with no significant difference between the two groups. However, cannulation time was significantly longer in the cap-assisted gastroscope group (7.6 min vs. 5.8 min, p = 0.011). Complications occurred only in the cap-assisted gastroscope group, including one perforation (2.2%) and two cases of pancreatitis (4.4%), though the overall complication rate was not significantly different. Among the 40 patients (50.7%) who failed ERCP, percutaneous transhepatic biliary drainage (PTBD) was the most common rescue intervention (55%), followed by other procedures, including percutaneous gallbladder drainage, repeated ERCP, surgery, and conservative treatment. Both cap-assisted gastroscopes and duodenoscopes are viable options for ERCP in patients with Billroth II anastomosis. However, cannulation time was significantly shorter in the duodenoscope group.

Background/Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction is the standard treatment for common bile duct (CBD) stones. However, when complete removal is not feasible, the temporary placement of a plastic stent (PS) is commonly used. This study aimed to assess 12-month stent patency in elderly patients with CBD stones. Methods: This prospective study included patients aged 70 years or older who underwent ERCP with PS placement for CBD stones at Daegu Catholic University Medical Center from March to December 2023. Patients were followed every three months with laboratory tests and abdominal radiographs. Stent dysfunction was defined as either cholangitis or cholecystitis due to stent migration or occlusion. Results: Of 12 enrolled patients, 2 were lost to follow-up. The remaining 10 had a median age of 85 years. The median stone diameter and number were 16.5 mm and 3, respectively. Two patients (20%) experienced stent dysfunction at 1.4 and 2.7 months and underwent successful stent exchange. Of the remaining eight, one declined further ERCP, while seven underwent elective ERCP at 12 months. Among them, five achieved successful stone removal and two required stent exchange. Kaplan–Meier analysis showed 90% patency at 1.4 months and 80% at 2.7 months, maintained through 12 months. Conclusions: Plastic stents showed an acceptable 12-month patency in most elderly patients. Early complications suggest the need for close monitoring during the first three months, after which long-term stent maintenance may be feasible in selected cases. Larger studies are needed to validate these findings.

Ackground/Aims: The role of screening colonoscopy in older adults remains controversial because of procedural risks and limited life expectancy. We evaluated the diagnostic yield, procedural success, and safety of screening colonoscopy in patients aged ≥75 years.Methods: We retrospectively reviewed 602 patients aged ≥75 years who underwent screening colonoscopy between January 2013 and December 2024. Patients were stratified into two age groups: 75–79 years (n=486) and ≥80 years (n=116). Baseline characteristics, procedural outcomes, and safety were compared.Results: Baseline characteristics were comparable between groups. The detection rates were 10.5%, 6.8%, and 0.9% for non-advanced adenoma, advanced adenoma, and colorectal cancer, respectively. Cecal intubation success was high in both groups (98.1% vs. 99.1%, p=0.454), and adequate bowel preparation rates were similar (71.2% vs. 72.4%, p=0.880). Sedation was used less frequently in patients aged ≥80 years (65.5% vs. 76.7%, p=0.013). Complications were rare (1.5%) and comparable between groups, with only mild events.Conclusions: Screening colonoscopy in adults aged ≥75 years demonstrated high procedural success, substantial neoplasia detection rates, and low adverse event rates, with comparable outcomes in patients aged ≥80 years. However, overall clinical benefit should be interpreted cautiously, particularly in those aged ≥80 years, supporting an individualized approach.