Literature DB >> 20044765

Is outpatient ERCP suitable, feasible, and safe? The experience of a Spanish community hospital.

Luís Rábago1, Ivan Guerra, Marta Moran, Elvira Quintanilla, David Collado, Inmaculada Chico, Ana Olivares, Jose Luis Castro, Francisco Gea.   

Abstract

BACKGROUND: We wanted to evaluate the safety of outpatient endoscopic retrograde cholangiopancreatography (ERCP). The follow-up of an ERCP outpatient during a short observation period could be a feasible and safe approach.
METHODS: To evaluate the safety of outpatient ERCP, we assessed the rate of post-ERCP complications found and missed during a 6-h observation period after therapeutic ERCP.
RESULTS: We performed 236 ERCPs on an outpatient basis, with a failure rate of 3.7% but with an overall completion rate for the intended treatment of 90.7%. Seventy-eight percent of the ERCPs were primarily therapeutic. The age of the patients was 63.9 years and 61.9% were females. One hundred seventy-seven (74.5%) patients were discharged from the hospital after the observation period. Thirty-three (14.1%) patients were admitted without further delay due to unexpected ERCP findings or for early detection of complications. Twenty-seven (11.4%) patients had a prolonged hospital stay because of complications during the observation period. Just two patients previously discharged developed later complications: cholangitis and pancreatitis (0.84% of the ERCPs and 7.4% of the overall complications). There were 27 ERCP complications (12.1%). Of the overall complications, 29.6% were diagnosed very early after the procedure and 62.9% were diagnosed during the observation period. 8.9% out of the 12.1% of the ERCP complications were mild to moderate. There was no mortality.
CONCLUSION: Twenty-five (92.6%) of ERCP complications occurred during the first 6 h, making the use of this short observation period safe for an early discharge. The evolution of the patients who developed delayed complications was unremarkable. Whenever outpatient ERCP is feasible, it should be done to help cut costs.

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Year:  2010        PMID: 20044765     DOI: 10.1007/s00464-009-0832-5

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  23 in total

1.  Same-day discharge after endoscopic biliary sphincterotomy: observations from a prospective multicenter complication study. The Multicenter Endoscopic Sphincterotomy (MESH) Study Group.

Authors:  M L Freeman; D B Nelson; S Sherman; G B Haber; M B Fennerty; J A DiSario; M E Ryan; P P Kortan; P J Dorsher; M J Shaw; M E Herman; J T Cunningham; J P Moore; W B Silverman; J C Imperial; R D Mackie; P A Jamidar; P N Yakshe; G M Logan; A M Pheley
Journal:  Gastrointest Endosc       Date:  1999-05       Impact factor: 9.427

2.  Complications of ERCP.

Authors:  J Shawn Mallery; Todd H Baron; Jason A Dominitz; Jay L Goldstein; William K Hirota; Brian C Jacobson; Jonathan A Leighton; Hareth M Raddawi; John J Varg; J Patrick Waring; Robert D Fanelli; Jo Wheeler-Harbough; Glenn M Eisen; Douglas O Faigel
Journal:  Gastrointest Endosc       Date:  2003-05       Impact factor: 9.427

3.  A prospective series of out-patient endoscopic retrograde cholangiopancreatography.

Authors:  C J Fox; R A Harry; S R Cairns
Journal:  Eur J Gastroenterol Hepatol       Date:  2000-05       Impact factor: 2.566

Review 4.  Are we meeting the standards set for ERCP?

Authors:  John Baillie; Pier-Alberto Testoni
Journal:  Gut       Date:  2007-06       Impact factor: 23.059

5.  Outpatient therapeutic ERCP: cutting sphincters and cutting costs.

Authors:  D J Bjorkman; J Van Dam
Journal:  Am J Gastroenterol       Date:  1996-08       Impact factor: 10.864

6.  Endoscopic sphincterotomy in outpatients.

Authors:  I Podolsky; P Kortan; G B Haber
Journal:  Gastrointest Endosc       Date:  1989 Sep-Oct       Impact factor: 9.427

7.  Risk factors for post-ERCP pancreatitis: a prospective, multicenter study.

Authors:  M L Freeman; J A DiSario; D B Nelson; M B Fennerty; J G Lee; D J Bjorkman; C S Overby; J Aas; M E Ryan; G S Bochna; M J Shaw; H W Snady; R V Erickson; J P Moore; J P Roel
Journal:  Gastrointest Endosc       Date:  2001-10       Impact factor: 9.427

8.  Endoscopic sphincterotomy-induced hemorrhage: treatment with multipolar electrocoagulation.

Authors:  S Sherman; R H Hawes; R Nisi; G A Lehman
Journal:  Gastrointest Endosc       Date:  1992 Mar-Apr       Impact factor: 9.427

9.  Therapeutic ERCP in outpatients.

Authors:  T C Tham; J Vandervoort; R C Wong; D R Lichtenstein; J Van Dam; F Ruymann; F Farraye; D L Carr-Locke
Journal:  Gastrointest Endosc       Date:  1997-03       Impact factor: 9.427

Review 10.  ERCP as an outpatient treatment: a review.

Authors:  Suzanne M Jeurnink; Jan Werner Poley; Ewout W Steyerberg; Ernst J Kuipers; Peter D Siersema
Journal:  Gastrointest Endosc       Date:  2008-03-04       Impact factor: 9.427

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  2 in total

1.  Predicting native papilla biliary cannulation success using a multinational Endoscopic Retrograde Cholangiopancreatography (ERCP) Quality Network.

Authors:  Chunyan Peng; Paul J Nietert; Peter B Cotton; Daniel T Lackland; Joseph Romagnuolo
Journal:  BMC Gastroenterol       Date:  2013-10-10       Impact factor: 3.067

2.  Therapeutic Endoscopy Can Be Performed Safely in an Ambulatory Surgical Center: A Multicenter, Prospective Study.

Authors:  Shaffer R S Mok; Henry C Ho; John P Gaughan; Adam B Elfant
Journal:  Diagn Ther Endosc       Date:  2016-10-20
  2 in total

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