Abstract
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.
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Abbreviations
- ERCP:
-
Endoscopic Retrograde Cholangiopancreatography
- US:
-
United States
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MTB and RG conceptualized and designed the study, drafted the initial manuscript, analyzed the data, and critically reviewed and revised the manuscript. AY-JL critically reviewed the manuscript and data analysis/presentation and revised the manuscript.
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An invited commentary on this article is available at https://doi.org/10.1007/s10620-024-08327-7”
Most pediatric ERCPs in the US are performed on an inpatient basis. We recently shifted our interventional endoscopy practice toward performing a subset of pediatric ERCPs on an outpatient basis. The present study attests to the safety of outpatient ERCP for this subset of patients in this context.
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Barakat, M.T., Liman, A.YJ. & Gugig, R. Pediatric ERCP: Evolving into an Outpatient Procedure. Dig Dis Sci (2024). https://doi.org/10.1007/s10620-024-08325-9
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DOI: https://doi.org/10.1007/s10620-024-08325-9