Background

While most adult ERCPs are performed on an outpatient basis, pediatric ERCPs are typically performed on an inpatient basis, or with ERCP followed by at least one night inpatient admission. We have begun performing a substantial proportion of our pediatric ERCPs on an outpatient basis, using our clinical judgment to guide the decision process. In the present study, we compare patient characteristics, indications, and adverse events associated with outpatient vs. inpatient ERCP.

Methods

Using our endoscopy database, we identified patients 18 years of age and under who underwent ERCP from 2019 to 2021. Demographics, hospitalization status, indications, findings, interventions, as well as available adverse event and clinical outcomes data were analyzed.

Results

147 ERCP procedures were performed during the study period by one of two interventional endoscopists. A subset of 51 (34.7%) patients underwent outpatient ERCP. Comparison of the two groups (outpatient vs. inpatient ERCP) was notable for no statistically significant difference in patient age, range of indications, or proportion of index vs. subsequent ERCP. Overall rates of ERCP-associated adverse events were low and there was no statistically significant difference between adverse events in patients who underwent outpatient vs. inpatient ERCP.

Conclusion

We analyzed outpatient and inpatient pediatric ERCP patient demographics and ERCP characteristics to identify factors that guide decision to determine whether pediatric ERCPs are performed on an outpatient vs. inpatient basis. There was no significant difference in adverse events associated with outpatient vs. inpatient pediatric ERCPs, attesting to the safety of outpatient ERCP for this subset of patients in the studied context. This is an area worthy of future prospective and multi-center study.

中文翻译：

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儿科 ERCP：演变为门诊手术

背景

虽然大多数成人 ERCP 是在门诊进行的，但儿科 ERCP 通常是在住院患者中进行的，或者在进行 ERCP 后至少住院一晚。我们已经开始在门诊进行大部分儿科 ERCP，利用我们的临床判断来指导决策过程。在本研究中，我们比较了门诊与住院 ERCP 相关的患者特征、适应症和不良事件。

方法

使用我们的内窥镜数据库，我们确定了 2019 年至 2021 年接受 ERCP 的 18 岁及以下患者。对人口统计、住院状态、适应症、结果、干预措施以及可用的不良事件和临床结果数据进行了分析。

结果

研究期间，两名介入内窥镜医师之一进行了 147 例 ERCP 手术。51 名患者 (34.7%) 接受了门诊 ERCP 治疗。两组（门诊患者与住院患者 ERCP）的比较值得注意的是，患者年龄、适应症范围或指数与后续 ERCP 的比例没有统计学上的显着差异。ERCP 相关不良事件的总体发生率较低，并且接受门诊 ERCP 的患者与住院患者的不良事件之间没有统计学上的显着差异。

结论

我们分析了门诊和住院儿科 ERCP 患者的人口统计数据和 ERCP 特征，以确定指导决策的因素，以确定儿科 ERCP 是在门诊还是住院进行。与门诊儿科 ERCP 相关的不良事件与住院儿科 ERCP 相关的不良事件没有显着差异，证明了门诊 ERCP 对于研究背景下的这部分患者的安全性。这是一个值得未来前瞻性、多中心研究的领域。