Outpatients undergoing therapeutic endoscopic retrograde cholangiopancreatography: six-hour versus overnight observation.

Abstract

The purpose of the present retrospective study was to compare the proportion of post-endoscopic retrograde cholangiopancreatography (ERCP) complications detected with 6-h observation followed by same-day discharge (SDD) versus overnight observation (OO) after therapeutic ERCP. There were 134 outpatients in the SDD group and 178 outpatients in the OO group. The SDD group was discharged after a 6-h observation while the OO group was discharged after overnight observation. Patients in the SDD group were admitted from the recovery room for evaluation if they had systolic blood pressure (BP) < 100 mmHg, pulse > 100/min, temperature > 37.5 degrees C, or post-procedure abdominal pain. The primary outcome of the present study was the proportion of post-ERCP complications detected within the observational period between the SDD group and the OO group. The post-ERCP complication rate of therapeutic ERCP in the SDD and OO groups were 9.7% and 9.6%, respectively (P = 0.964). Eleven patients (8.2%) in the SDD group and 13 patients (7.3%) in the OO group were found to have post-ERCP complications within the observation period. There was no significant difference in the proportion of post-ERCP complications detected within the observational period between the two groups (P = 0.672). Outpatient therapeutic ERCP with observation of 6 h can detect the same proportion of patients with post-ERCP complications as overnight observation.