Abstract: Objective: To investigate the clinical characteristics and safety of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of superelderly patients with cholecystopancreatic diseases. Methods: One hundred and twenty elderly patients aged 85 years or older with cholecystopancreatic diseases who underwent therapeutic ERCP were selected as the superelderly group,and another 180 patients aged 50-70 years during the same period with cholecystopancreatic diseases were randomly selected as the non-superlderly group.The clinical indicators such as primary diseases,complicated diseases,ASA classification,surgical failure rate,difficult intubation rate,coexisting periampullary diverticula (PAD),and postoperative complications between the two groups were compared. Results: The primary diseases of patients in the two groups were mainly choledocholithiasis,and the proportion of patients with malignant tumors of the biliary and pancreatic ducts in the superelderly group was higher than that in the non-superelderly group (P<0.05).The proportions of patients with hypertension,heart disease,stroke,pulmonary disease complications,and total complications in the superelderly group were significantly higher than those in the non-elderly group (P<0.01),and the proportion of patients complicated with two/three or more chronic diseases was also significantly higher than that in the non-superelderly group (P<0.01).There were significant differences in ASA classification between the two groups (P<0.01).The proportions of emergency ERCP and complicated PAD in the superelderly group were higher than those in the non-superelderly group (P<0.05).The proportions of difficult intubation and surgical failure in the superelderly group were higher than those in the non-superelderly group,but there were no statistically significant differences between the two groups (P>0.05).There were no statistically significant differences in hyperamylasemia,post-ERCP pancreatitis,bleeding,biliary tract infection,and total complications of patients between the two groups(P>0.05),and there were no cases of perforation or death in the two groups. Conclusions: The proportion of malignant biliary and pancreatic tumors is high in superelderly patients with cholecystopancreatic diseases,and the patients are complicated with multiple chronic basic diseases and with high ASA classification.But compared with non-superelderly patients with cholecystopancreatic diseases,the surgical failure rate and postoperative complications in superelderly patients with cholecystopancreatic diseases are not significantly increased.Therefore,ERCP in the treatment of superelderly patients with cholecystopancreatic diseases is effective and safe.