Abstract
EARLY VERSUS LATE ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN ACUTE BILIARY PANCREATITIS WITHOUT CHOLANGITIS: A NATIONAL SURVEY
Gastrointestinal endoscopy, Vol.95(6 Supplement), pp.AB330-AB330
06/2022
DOI: 10.1016/j.gie.2022.04.860
Abstract
Introduction
Patients with pancreatitis and cholangitis should undergo early endoscopic retrograde cholangiopancreatography (ERCP). However, the optimal timing to perform ERCP in patients with acute biliary pancreatitis (ABP) without cholangitis remains unclear. Therefore, we aimed to assess the hospital-related outcomes in patients with ABP without cholangitis who underwent early ERCP (<24 hours) as compared to late ERCP (24-72 hours) using the national inpatient sample (NIS).
Methods
We used ICD-10 CM/PCS codes to identify patients with ABP without acute cholangitis who underwent ERCP in 2019. We excluded pediatric patients (age<18 years) and those with acute cholangitis. Our primary outcomes included all- cause nontraumatic inpatient mortality, and secondary outcomes included mean length of stay (LOS) and total hospitalization cost. We conducted univariate and multivariate logistic and regression analyses to identify the predictors of mortality, LOS, and hospitalization cost.
Results
A total of 82,359 ABP-related hospitalizations met our study criteria, and out of those, 11055 (13.42%) had early ERCPs performed, and 7495 (9.1%) had late ERCP’s performed. Patients in the early ERCP group were younger (mean age 57.67 vs. 58.73) than the non-ERCP group. The overall inpatient mortality in the early ERCP was recorded 0.54% (n=60) compared to 0.26% (n=20), and mean LOS for the patients in the ERCP was 4.43 days vs. 5.46 days, and inflation-adjusted hospitalization cost was calculated as $16,988.16 vs. $18,334.04.
Conclusion
Our study found that early ERCP in ABP without cholangitis is associated with shorter hospital stay and less hospitalization cost but at the expense of higher inpatient mortality compared to the late ERCP group. This provides evidence that delayed ERCP may be safer for patients with acute biliary pancreatitis without cholangitis.
Details
- Title: Subtitle
- EARLY VERSUS LATE ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN ACUTE BILIARY PANCREATITIS WITHOUT CHOLANGITIS: A NATIONAL SURVEY
- Creators
- Ahmad KhanAbdullah SohailKhadija NaseemAdnan MalikYousaf HadiSardar M. Shah-KhanShyam ThakkarShailendra Singh
- Resource Type
- Abstract
- Publication Details
- Gastrointestinal endoscopy, Vol.95(6 Supplement), pp.AB330-AB330
- DOI
- 10.1016/j.gie.2022.04.860
- ISSN
- 0016-5107
- eISSN
- 1097-6779
- Language
- English
- Date published
- 06/2022
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984695807302771
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