Technical failures and complications of diagnostic (Dx) and therapeutic (Tx) ERCP: Impact on resource utilization

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

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Abstract

In an ongoing prospective study involving ERCP in a wide spectrum of practice settings, we are examining technical success and complication rates, and their relative impact on utilization of resources. METHODS: Consecutive ERCP's attempted at 11 centers (6 private, 5 university) were enrolled. Procedure data were recorded at time of ERCP, and outcomes assessed at 30 days. Complications were defined by consensus criteria (Cotton et al), but included all procedure-related events. ERCP-related hospital days (=hosp-days) were defined as nights in hospital for observation, treatment of complications (=complic's), or for additional unplanned endoscopic, radiological, and surgical interventions due to failures or complic's of ERCP (=addt'l proc). RESULTS: Data are shown for the 486 cases (of 804 ERCP) which were performed on "virgin" papillae (no prior sphincterotomy or stent) and were done for "traditional" indications (Dx or biliary Tx only, without pancreatic sphincter or ductal Tx). "VIRGIN PAPILLA" ERCP (n=486) Diagnostic intended only (n=142) Technical Success Complete 86% Partial 8% Fail 6% Success 86% 8% 6% Complic's 6% 0% 22% Addt'l proc" 2% 18%* 22%* Hosp-days 0.8 ± 0.2 0.5 ± 0.2 3.6* ± 1.9 Biliary therapy intended (n=344) Technical Complete Partial Fail Success 87% 5% 8% Complic's 14% 17% 12% (n=344) Addt'l proc 4% 44%* 62%* Hosp-days 1.5 ± 0.1 2.7 ± 1.0 6.2* ± 1.8 *P

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume45
Issue number4
Publication statusPublished - 1997
Externally publishedYes

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ASJC Scopus subject areas

  • Gastroenterology

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Freeman, M. L., Nelson, D. B., Snady, H. W., DiSario, J. A., Overby, C. S., Ryan, M. E., ... Pheley, A. M. (1997). Technical failures and complications of diagnostic (Dx) and therapeutic (Tx) ERCP: Impact on resource utilization. Gastrointestinal Endoscopy, 45(4).