Endoscopy 2018; 50(04): S128-S129
DOI: 10.1055/s-0038-1637414
ESGE Days 2018 ePoster Podium presentations
21.04.2018 – ERCP: acute pancreatitis, stenting
Georg Thieme Verlag KG Stuttgart · New York

ERCP WITHIN 24 H OF ADMISSION DECREASES COMPLICATION RATE IN ACUTE BILIARY PANCREATITIS: SINGLE CENTRE EXPERIENCE IN 153 CONSECUTIVE PATIENTS

A Rihtaršič
1   University Medical Center Ljubljana, Department of Gastroenterology, Ljubljana, Slovenia
,
D Drobne
1   University Medical Center Ljubljana, Department of Gastroenterology, Ljubljana, Slovenia
2   Faculty of Medicine, University of Ljubljana, Department of Internal Medicine, Ljubljana, Slovenia
,
B Štabuc
1   University Medical Center Ljubljana, Department of Gastroenterology, Ljubljana, Slovenia
2   Faculty of Medicine, University of Ljubljana, Department of Internal Medicine, Ljubljana, Slovenia
,
S Plut
1   University Medical Center Ljubljana, Department of Gastroenterology, Ljubljana, Slovenia
2   Faculty of Medicine, University of Ljubljana, Department of Internal Medicine, Ljubljana, Slovenia
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

Aims:

Endoscopic retrograde cholangio-pancreatography (ERCP) in first 72 hours is a standard therapeutic procedure in patients with acute biliary pancreatitis, but it is not clear if even earlier procedure would add additional benefit. Therefore we aimed to explore if ERCP within 24 hours of admission decreases duration of hospitalization, the rate of systemic and local complications, and if this effect is limited only to patients with concomitant cholangitis.

Methods:

We retrospectively included 153 consecutive patients with acute biliary pancreatitis admitted to the tertiary referral university hospital between January 2012 and December 2013. Rate of local and systemic complications and duration of hospitalization in patients with very early ERCP (defined as within 24h of admission) was compared to patients with early ERCP (defined as with 72h of admission). p < 0.05 was considered significant.

Results:

153 patients developed 20 local and 22 systemic complications. The proportion of patients with local and systemic complications was significantly lower in a subgroup of patients with very early ERCP (performed after median of 0.75 day, interquartile range: 0.5 – 1.0) compared to early ERCP (performed after median of 2.0 days, interquartile range: 1.5 – 2.5). Furthermore, patients with very early ERCP had shorter duration of hospitalization compared to patients with early ERCP. Concomitant cholangitis did not affect the rate of local or systemic complications nor prolong hospitalization.

Tab. 1:

Impact of ERCP timing on outcome in acute

Total number of patients N = 153

ERCP within 24h N = 69/153 (45,1%)

ERCP within 72h N = 84/153 (54,9%)

p-value

Total time of hospitalization (days) – median with IQR

8.0 (5.0 – 10.0)

9.5 (6.0 – 19.0)

0.005

Patients with any complications No. (%)

7/69 (10,1%)

27/84 (32,1%)

0.001

Patients with local complications – No. (%)

4/69 (5,8%)

16/84 (19,0%)

0.016

Patients with systemic complications No. (%)

5/69 (7,2%)

17/84 (20,2%)

0.023

Conclusions:

ERCP within 24 hours of admission decreases the rate of local and systemic complications and duration of hospitalization compared to ERCP within 72 hours of admission in acute gallstone pancreatitis.