BACKGROUND: Physician fatigue and decreased concentration have been proposed as causes of lower completion and adenoma detection rates in afternoon colonoscopies compared with morning colonoscopies. ERCP is a technically demanding and highly operator-dependent procedure, and its success may similarly be affected in the afternoon compared with the morning. OBJECTIVE: To compare cannulation success and adverse events between ERCP procedures performed in the morning and afternoon. DESIGN: Retrospective cohort study. SETTING: Tertiary referral center. PATIENTS: Patients with no previous papillary intervention who underwent ERCP at our institution between November 2006 and November 2008. MAIN OUTCOME MEASUREMENTS: Cannulation success, procedure completion rates, length of procedures, and adverse events. RESULTS: A total of 296 patients were studied; 114 patients (38.5%) underwent a procedure in the morning and 182 patients (61.5%) underwent a procedure in the afternoon. There were 139 male patients (47.0%). The mean patient age was 59.1 years. The deep cannulation success rate was 95.3% overall, with similar rates when performed in the morning (98.3%) and afternoon (94.0%) (P = .08). When the start time was evaluated as a continuous hour-by-hour variable, there was also no significant difference in deep cannulation success rates (P = .30). Procedure completion rates were similar in both groups (morning, 93.9%; 94.0%, afternoon; P = .97). Adverse events (8.8% for morning procedures vs 7.1% for afternoon procedures, P = .61) and length of procedures (40 minutes for morning procedures vs 40 minutes for afternoon procedures, P = .87) were also similar between the 2 groups. LIMITATIONS: Small sample size and retrospective study. CONCLUSIONS: The timing of ERCP, morning versus afternoon, does not seem to affect cannulation success, procedure completion rates, length of procedures, or adverse events.
BACKGROUND: Physician fatigue and decreased concentration have been proposed as causes of lower completion and adenoma detection rates in afternoon colonoscopies compared with morning colonoscopies. ERCP is a technically demanding and highly operator-dependent procedure, and its success may similarly be affected in the afternoon compared with the morning. OBJECTIVE: To compare cannulation success and adverse events between ERCP procedures performed in the morning and afternoon. DESIGN: Retrospective cohort study. SETTING: Tertiary referral center. PATIENTS: Patients with no previous papillary intervention who underwent ERCP at our institution between November 2006 and November 2008. MAIN OUTCOME MEASUREMENTS: Cannulation success, procedure completion rates, length of procedures, and adverse events. RESULTS: A total of 296 patients were studied; 114 patients (38.5%) underwent a procedure in the morning and 182 patients (61.5%) underwent a procedure in the afternoon. There were 139 male patients (47.0%). The mean patient age was 59.1 years. The deep cannulation success rate was 95.3% overall, with similar rates when performed in the morning (98.3%) and afternoon (94.0%) (P = .08). When the start time was evaluated as a continuous hour-by-hour variable, there was also no significant difference in deep cannulation success rates (P = .30). Procedure completion rates were similar in both groups (morning, 93.9%; 94.0%, afternoon; P = .97). Adverse events (8.8% for morning procedures vs 7.1% for afternoon procedures, P = .61) and length of procedures (40 minutes for morning procedures vs 40 minutes for afternoon procedures, P = .87) were also similar between the 2 groups. LIMITATIONS: Small sample size and retrospective study. CONCLUSIONS: The timing of ERCP, morning versus afternoon, does not seem to affect cannulation success, procedure completion rates, length of procedures, or adverse events.
Authors: Yonatan J Hillman; Bari S Hillman; Divyesh V Sejpal; Calvin Lee; Larry S Miller; Petros C Benias; Arvind J Trindade Journal: United European Gastroenterol J Date: 2018-10-11 Impact factor: 4.623
Authors: Jason Korenblit; Danielle M Tholey; Joanna Tolin; David Loren; Thomas Kowalski; Douglas G Adler; Julie Davolos; Ali A Siddiqui Journal: Endosc Ultrasound Date: 2016 Mar-Apr Impact factor: 5.628
Authors: Daniel Eshtiaghpour; John M Iskander; Inder M Singh; David S Chung; Viktor E Eysselein; Sofiya Reicher Journal: Endosc Ultrasound Date: 2016 May-Jun Impact factor: 5.628