Does the Time of Day have an Effect on the Success and Complications of ERCP?

Abstract

Abstract: Background: In ERCP, if modifiable risk factors can be minimized, indirectly, the rates of complications will also decrease. Objective: In the present study, the aim is to investigate whether the timing of ERCP (morning versus afternoon) was associated with the success of cannulation and procedure-related complications in patients with bile duct stones undergoing ERCP. Materials and Methods: This is a retrospective study of patients who underwent ERCP for common bile duct (CBD) stones. We compared the complication rate and the success of CBD cannulation between procedures conducted in the morning and those carried out in the afternoon during ERCP. Result: A total of 402 patients were enrolled. The mean age of patients was 64.4 ± 19 years with a total bilirubin value of 7.5 ± 11.6 mg/dL, direct bilirubin value of 4.9 ± 8.6 mg/dL, and CBD of 11±2.4 mm. 201 (50%) of the patients underwent ERCP in the morning and 201 (50%) in the afternoon. The rates of post-ERCP pancreatitis, bleeding, and the success of cannulation were 5.5%, 10%, and 96.5% in the morning ERCP group and 5%, 13.4%, and 93% in the afternoon ERCP group, respectively. There were no statistically significant differences between groups in post-ERCP pancreatitis (p=0.606), bleeding (p=0.277), and the success of CBD cannulation (p=0.117). Conclusion: Between morning and afternoon ERCP procedures, no statistically significant difference was detected. Keywords: ERCP, Ampulla vateri cannulation, ERCP complication, Time-of-day, ERCP timing, Cholangitis, Choledocholithiasis.