Outcomes of pancreatic therapeutic ERCP as compared with biliary therapeutic and diagnostic ERCP

A prospective multisite study

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

Research output: Contribution to journalArticle

Abstract

Endoscopic therapeutics on the pancreatic sphincter(s) and duct(s) (Pancr-Tx) are increasingly performed at tertiary centers, yet little is known of their utilization or outcomes in other settings. Methods: All consecutive ERCP's attempted at 11 centers (6 private, 5 university) were prospectively studied. Procedure data were recorded at time of ERCP and outcomes were assessed at 30 days. Complications were denned by established consensus criteria, and included indirect events. Intent-to-treat was considered a success only if sphincterotomy (ES), stone clearance, stricture drainage or other Tx of the intended duct(s) was total at first procedure. Results: Of 1,586 ERCP, intent was biliary Tx only in 1,019 (64%), Dx only in 341 (22%), and Pancr-Tx in 226 (14%). Intended Pancr-Tx comprised 22% of all ERCP at academic centers vs 5% in private practices. Intended Pancr-Tx included pancreatic stent insertion (n=167) and/or removal (n = 68), pancreatic ES of major (n=60) or minor papilla (n = 22), stricture dilation (n = 53), pancreatic stone extraction (n = 17), tissue sampling (n = 14), and other Tx (n = 14). Dx only n = 341 Biliary Tx n=1,019 Pancr-Tx n=226 % including ES 0% 65% bil ES 35% pancrES Success rate 90% 88% 85% Complications 6.5% 10.8% 24.8%*(Pancreatitis) (5.9%) (4.2%) (18.2%)*(Severe cpmpl'ns) (0.9%) (1.2%) (1.3%) ERCP-related hospital daysmean = 1.0 ± 0.1*mean = 1.6 ± 0.1 mean = 2.0 ± 0.3*P

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

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Endoscopic Retrograde Cholangiopancreatography
Prospective Studies
Pathologic Constriction
Therapeutics
Private Practice
Pancreatitis
Stents
Dilatation
Drainage

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Freeman, M. L., Nelson, D. B., DiSario, J. A., Overby, C. S., Erickson, R. V., Ryan, M. E., ... Pheley, A. M. (1998). Outcomes of pancreatic therapeutic ERCP as compared with biliary therapeutic and diagnostic ERCP: A prospective multisite study. Gastrointestinal Endoscopy, 47(4).

Outcomes of pancreatic therapeutic ERCP as compared with biliary therapeutic and diagnostic ERCP : A prospective multisite study. / Freeman, M. L.; Nelson, D. B.; DiSario, J. A.; Overby, C. S.; Erickson, R. V.; Ryan, M. E.; Bochna, G. S.; Shaw, M. J.; Moore, J. P.; Snady, H. W.; Fennerty, M (Brian); Lee, J. G.; Pheley, A. M.

In: Gastrointestinal Endoscopy, Vol. 47, No. 4, 1998.

Research output: Contribution to journalArticle

Freeman, ML, Nelson, DB, DiSario, JA, Overby, CS, Erickson, RV, Ryan, ME, Bochna, GS, Shaw, MJ, Moore, JP, Snady, HW, Fennerty, MB, Lee, JG & Pheley, AM 1998, 'Outcomes of pancreatic therapeutic ERCP as compared with biliary therapeutic and diagnostic ERCP: A prospective multisite study', Gastrointestinal Endoscopy, vol. 47, no. 4.
Freeman, M. L. ; Nelson, D. B. ; DiSario, J. A. ; Overby, C. S. ; Erickson, R. V. ; Ryan, M. E. ; Bochna, G. S. ; Shaw, M. J. ; Moore, J. P. ; Snady, H. W. ; Fennerty, M (Brian) ; Lee, J. G. ; Pheley, A. M. / Outcomes of pancreatic therapeutic ERCP as compared with biliary therapeutic and diagnostic ERCP : A prospective multisite study. In: Gastrointestinal Endoscopy. 1998 ; Vol. 47, No. 4.
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abstract = "Endoscopic therapeutics on the pancreatic sphincter(s) and duct(s) (Pancr-Tx) are increasingly performed at tertiary centers, yet little is known of their utilization or outcomes in other settings. Methods: All consecutive ERCP's attempted at 11 centers (6 private, 5 university) were prospectively studied. Procedure data were recorded at time of ERCP and outcomes were assessed at 30 days. Complications were denned by established consensus criteria, and included indirect events. Intent-to-treat was considered a success only if sphincterotomy (ES), stone clearance, stricture drainage or other Tx of the intended duct(s) was total at first procedure. Results: Of 1,586 ERCP, intent was biliary Tx only in 1,019 (64{\%}), Dx only in 341 (22{\%}), and Pancr-Tx in 226 (14{\%}). Intended Pancr-Tx comprised 22{\%} of all ERCP at academic centers vs 5{\%} in private practices. Intended Pancr-Tx included pancreatic stent insertion (n=167) and/or removal (n = 68), pancreatic ES of major (n=60) or minor papilla (n = 22), stricture dilation (n = 53), pancreatic stone extraction (n = 17), tissue sampling (n = 14), and other Tx (n = 14). Dx only n = 341 Biliary Tx n=1,019 Pancr-Tx n=226 {\%} including ES 0{\%} 65{\%} bil ES 35{\%} pancrES Success rate 90{\%} 88{\%} 85{\%} Complications 6.5{\%} 10.8{\%} 24.8{\%}*(Pancreatitis) (5.9{\%}) (4.2{\%}) (18.2{\%})*(Severe cpmpl'ns) (0.9{\%}) (1.2{\%}) (1.3{\%}) ERCP-related hospital daysmean = 1.0 ± 0.1*mean = 1.6 ± 0.1 mean = 2.0 ± 0.3*P",
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T1 - Outcomes of pancreatic therapeutic ERCP as compared with biliary therapeutic and diagnostic ERCP

T2 - A prospective multisite study

AU - Freeman, M. L.

AU - Nelson, D. B.

AU - DiSario, J. A.

AU - Overby, C. S.

AU - Erickson, R. V.

AU - Ryan, M. E.

AU - Bochna, G. S.

AU - Shaw, M. J.

AU - Moore, J. P.

AU - Snady, H. W.

AU - Fennerty, M (Brian)

AU - Lee, J. G.

AU - Pheley, A. M.

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N2 - Endoscopic therapeutics on the pancreatic sphincter(s) and duct(s) (Pancr-Tx) are increasingly performed at tertiary centers, yet little is known of their utilization or outcomes in other settings. Methods: All consecutive ERCP's attempted at 11 centers (6 private, 5 university) were prospectively studied. Procedure data were recorded at time of ERCP and outcomes were assessed at 30 days. Complications were denned by established consensus criteria, and included indirect events. Intent-to-treat was considered a success only if sphincterotomy (ES), stone clearance, stricture drainage or other Tx of the intended duct(s) was total at first procedure. Results: Of 1,586 ERCP, intent was biliary Tx only in 1,019 (64%), Dx only in 341 (22%), and Pancr-Tx in 226 (14%). Intended Pancr-Tx comprised 22% of all ERCP at academic centers vs 5% in private practices. Intended Pancr-Tx included pancreatic stent insertion (n=167) and/or removal (n = 68), pancreatic ES of major (n=60) or minor papilla (n = 22), stricture dilation (n = 53), pancreatic stone extraction (n = 17), tissue sampling (n = 14), and other Tx (n = 14). Dx only n = 341 Biliary Tx n=1,019 Pancr-Tx n=226 % including ES 0% 65% bil ES 35% pancrES Success rate 90% 88% 85% Complications 6.5% 10.8% 24.8%*(Pancreatitis) (5.9%) (4.2%) (18.2%)*(Severe cpmpl'ns) (0.9%) (1.2%) (1.3%) ERCP-related hospital daysmean = 1.0 ± 0.1*mean = 1.6 ± 0.1 mean = 2.0 ± 0.3*P

AB - Endoscopic therapeutics on the pancreatic sphincter(s) and duct(s) (Pancr-Tx) are increasingly performed at tertiary centers, yet little is known of their utilization or outcomes in other settings. Methods: All consecutive ERCP's attempted at 11 centers (6 private, 5 university) were prospectively studied. Procedure data were recorded at time of ERCP and outcomes were assessed at 30 days. Complications were denned by established consensus criteria, and included indirect events. Intent-to-treat was considered a success only if sphincterotomy (ES), stone clearance, stricture drainage or other Tx of the intended duct(s) was total at first procedure. Results: Of 1,586 ERCP, intent was biliary Tx only in 1,019 (64%), Dx only in 341 (22%), and Pancr-Tx in 226 (14%). Intended Pancr-Tx comprised 22% of all ERCP at academic centers vs 5% in private practices. Intended Pancr-Tx included pancreatic stent insertion (n=167) and/or removal (n = 68), pancreatic ES of major (n=60) or minor papilla (n = 22), stricture dilation (n = 53), pancreatic stone extraction (n = 17), tissue sampling (n = 14), and other Tx (n = 14). Dx only n = 341 Biliary Tx n=1,019 Pancr-Tx n=226 % including ES 0% 65% bil ES 35% pancrES Success rate 90% 88% 85% Complications 6.5% 10.8% 24.8%*(Pancreatitis) (5.9%) (4.2%) (18.2%)*(Severe cpmpl'ns) (0.9%) (1.2%) (1.3%) ERCP-related hospital daysmean = 1.0 ± 0.1*mean = 1.6 ± 0.1 mean = 2.0 ± 0.3*P

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