ERCP as an outpatient treatment: a review.

摘要

BACKGROUND: ERCP on an outpatient basis could be as safe as on an inpatient basis and may also reduce medical costs. OBJECTIVE: To review the available literature to determine the safety of an ERCP performed on an outpatient basis. DESIGN: A review of the published literature was performed by searching PubMed, the Cochrane Library, EMBASE, and the Web of Science. PATIENTS: Patients who were undergoing an ERCP. INTERVENTIONS: An ERCP on an inpatient or outpatient basis. MAIN OUTCOME MEASUREMENTS: Patient and treatment characteristics, complications, and prolonged hospital admissions and readmissions. RESULTS: Eleven studies were included in this review, of which 5 were comparative studies, 5 were prospective studies, and 1 was a retrospective study. In these series, a total of 2483 patients underwent an ERCP on an outpatient basis and 2320 patients were admitted overnight after an ERCP. Complications were seen in 184 of 2483 outpatients (7%), of which 72% of complications (107/149) presented within 2 to6 hours, 10% (15/149) within 6 to 24 hours, and 18% (27/149) more than 24 hours after the ERCP. Three percent of the inpatients (82/2320) developed a complication, of which 95% of complications (78/82) presented within 24 hours and 5% (4/82) presented more than 24 hours after the ERCP. A prolonged hospital stay after an ERCP was indicated in 6% of the designated outpatients (148/2483), whereas 3% of outpatients (74/2149) and 1% of inpatients (4/2320) were readmitted after discharge. LIMITATIONS: Limited data available. CONCLUSIONS: This review shows that, with a selective policy, an ERCP on an outpatient basis seems as safe as when performed on an inpatient basis.