Endoscopic Papillectomy May Be a Feasible Treatment Option for Elderly Patients With Ampullary Tumors: A Multicenter Retrospective Study.

OBJECTIVES: Endoscopic papillectomy (EP) is a minimally invasive treatment for ampullary tumors; however, its safety in elderly patients remains unclear. We aimed to evaluate the feasibility and clinical outcomes of EP in this population. METHODS: This multicenter retrospective study included 255 patients with ampullary tumors who underwent EP between April 2008 and September 2025 at three collaborating institutions. Patients aged ≥ 75 years were defined as elderly; complication rates and clinical outcomes were compared with the non-elderly group. RESULTS: The elderly group had a significantly higher Charlson Comorbidity Index (1.0 [0-8] vs. 0 [0-7]; p = 0.028). The elderly group demonstrated significantly lower rates of overall complications (29.0% vs. 48.9%; p = 0.004), delayed bleeding (4.3% vs. 23.1%; p < 0.001), and pancreatitis (11.6% vs. 23.1%; p = 0.041) than the non-elderly group. Serious complications rate (4.3% vs. 4.8%; p = 1.000), median hospital stay (12 [7-73] vs. 13 [4-40] days; p = 0.408) were comparable between groups. Multivariate analysis showed that age ≥ 75 years was independently associated with a reduced risk of delayed bleeding (p = 0.002; odds ratio [OR], 0.14) and pancreatitis (p = 0.029; OR, 0.39). CONCLUSIONS: EP in patients aged ≥ 75 years was associated with lower complication rates and may be a feasible treatment option.