Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
Scand J Gastroenterol. 2021 Oct;56(10):1243-1247. doi: 10.1080/00365521.2021.1955148. Epub 2021 Jul 26.
Patients with suspected choledocholithiasis should undergo further confirmatory imaging test by endoscopic ultrasound (EUS) or magnetic resonance cholangiopancreatography (MRCP) before performing definite extraction by endoscopic retrograde cholangiopancreatography (ERCP). Usually, those procedures are performed at a separate session.
The aim of our study is to report the safety, efficacy and cost-effectiveness of same day EUS and ERCP.
A retrospective study including all patients who underwent EUS and ERCP for choledocholithiasis from 1st January 2020 through 1st January 2021. Patients were categorized into same day EUS and ERCP (group A) and separate day procedures (group B). Univariate descriptive analysis was done to compare between the groups and cost-effectiveness analysis was based on the length of hospitalization.
Sixty-one patients (57.5%) underwent same day EUS and ERCP (group A), as compared to 45 patients (42.5%) who had separate sessions (group B). The average ages in groups A and B were 66.1 ± 20.7 years and 65.8 ± 19.3 years, respectively ( = .47). There was no difference in the mean doses of midazolam, propofol and fentanyl in EUS and ERCP examinations in both groups. Notably, group A had a significantly lower hospitalization length as compared to group B (7.4 ± 2.9 vs. 9.7 ± 3.9 days, = .0003). Consequently, same day EUS and ERCP was associated with a significant cost saving as compared to group B (7680.9$ ± 3071.4$vs 10089.4$±4053.4$, = .0003), respectively. There was no serious anesthesia related adverse events.
Same day EUS and ERCP for choledocholithiasis was safe and cost-effective with significant lower hospitalization length.
疑似胆总管结石的患者应在进行经内镜逆行胰胆管造影术（ERCP）之前，通过内镜超声（EUS）或磁共振胰胆管成像（MRCP）进行进一步的确认性影像学检查。通常，这些程序是在单独的时间段进行的。
本研究旨在报告同日行 EUS 和 ERCP 的安全性、疗效和成本效益。
一项回顾性研究，纳入了 2020 年 1 月 1 日至 2021 年 1 月 1 日期间因胆总管结石而行 EUS 和 ERCP 的所有患者。患者分为同日行 EUS 和 ERCP（A 组）和分日进行的程序（B 组）。对两组间进行单变量描述性分析，并基于住院时间进行成本效益分析。
61 例患者（57.5%）同日行 EUS 和 ERCP（A 组），而 45 例患者（42.5%）分日进行（B 组）。A 组和 B 组的平均年龄分别为 66.1±20.7 岁和 65.8±19.3 岁（=0.47）。两组 EUS 和 ERCP 检查中咪达唑仑、丙泊酚和芬太尼的平均剂量无差异。值得注意的是，与 B 组相比，A 组的住院时间明显更短（7.4±2.9 天 vs. 9.7±3.9 天，=0.0003）。因此，与 B 组相比，同日行 EUS 和 ERCP 可显著节省成本（7680.9$±3071.4$vs 10089.4$±4053.4$，=0.0003）。没有发生严重的麻醉相关不良事件。
同日行 EUS 和 ERCP 治疗胆总管结石是安全且具有成本效益的，可显著缩短住院时间。
