Failures and complications of attempted therapeutic ERCP: Impact on outcomes and costs

M. L. Freeman, D. B. Nelson, G. M. Eisen, J. A. DiSario, H. W. Snady, C. S. Overby, R. V. Erickson, M. E. Ryan, G. S. Bochna, M. J. Shaw, J. P. Moore, M (Brian) Fennerty, J. G. Lee, A. M. Pheley

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Abstract

Although complications are obvious negative outcomes of ERCP, the relative impact and costs of technical failures has not been formally studied. METHODS: Consecutive ERCP's attempted at 11 centers (6 private, 5 university) were prospectively studied. Procedure data were recorded at time of ERCP and outcomes at 30 days. Complications were defined by consensus criteria, but also included indirectly-related events. All cases of biliary obstruction plus those designated by the endoscopist were considered intended biliary therapeutic (Tx). Biliary Tx was considered complete only if all components were successful at that procedure; partial for incomplete stone extraction or stricture drainage; and failed if the bile duct was not accessed and drained for any reason. ERCP-related hospital days (= ERCP-hosp days) were denned as total nights in-hospital for observation, treatment of complications, and for Additional Procedures (subsequent unplanned endoscopic, radiological, surgical or other interventions due to failures or complications of ERCP). Costs of post-ERCP hospital care were estimated using 1996 HCFA reimbursements for ERCP-hosp days, additional procedures, MD and ER visits. RESULTS: Of 1,586 ERCP's, 1,019 (64%) were intended for biliary Tx; 341 Dx cases and 226 pancreatic Tx cases were excluded as intended goals vary widely between centers. Outcomes of 1,019 Biliary Tx ERCP (*P

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume47
Issue number4
Publication statusPublished - 1998
Externally publishedYes

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ASJC Scopus subject areas

  • Gastroenterology

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Freeman, M. L., Nelson, D. B., Eisen, G. M., DiSario, J. A., Snady, H. W., Overby, C. S., ... Pheley, A. M. (1998). Failures and complications of attempted therapeutic ERCP: Impact on outcomes and costs. Gastrointestinal Endoscopy, 47(4).