ERCP as an outpatient treatment: a review

BackgroundERCP on an outpatient basis could be as safe as on an inpatient basis and may also reduce medical costs.ObjectiveTo review the available literature to determine the safety of an ERCP performed on an outpatient basis.DesignA review of the published literature was performed by searching PubMed, the Cochrane Library, EMBASE, and the Web of Science.PatientsPatients who were undergoing an ERCP.InterventionsAn ERCP on an inpatient or outpatient basis.Main Outcome MeasurementsPatient and treatment characteristics, complications, and prolonged hospital admissions and readmissions.ResultsEleven 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 to 6 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.LimitationsLimited data available.ConclusionsThis review shows that, with a selective policy, an ERCP on an outpatient basis seems as safe as when performed on an inpatient basis.