Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Division of Pediatric Gastroenterology, Hepatology & Nutrition, Lucille Packard Children's Hospital at Stanford, Stanford, CA, 94305, USA.
Dig Dis Sci. 2024 Jun;69(6):1972-1978. doi: 10.1007/s10620-024-08325-9. Epub 2024 Feb 28.
While most adult ERCPs are performed on an outpatient basis, pediatric ERCPs are typically performed on an inpatient basis, or with ERCP followed by at least one night inpatient admission. We have begun performing a substantial proportion of our pediatric ERCPs on an outpatient basis, using our clinical judgment to guide the decision process. In the present study, we compare patient characteristics, indications, and adverse events associated with outpatient vs. inpatient ERCP.
Using our endoscopy database, we identified patients 18 years of age and under who underwent ERCP from 2019 to 2021. Demographics, hospitalization status, indications, findings, interventions, as well as available adverse event and clinical outcomes data were analyzed.
147 ERCP procedures were performed during the study period by one of two interventional endoscopists. A subset of 51 (34.7%) patients underwent outpatient ERCP. Comparison of the two groups (outpatient vs. inpatient ERCP) was notable for no statistically significant difference in patient age, range of indications, or proportion of index vs. subsequent ERCP. Overall rates of ERCP-associated adverse events were low and there was no statistically significant difference between adverse events in patients who underwent outpatient vs. inpatient ERCP.
We analyzed outpatient and inpatient pediatric ERCP patient demographics and ERCP characteristics to identify factors that guide decision to determine whether pediatric ERCPs are performed on an outpatient vs. inpatient basis. There was no significant difference in adverse events associated with outpatient vs. inpatient pediatric ERCPs, attesting to the safety of outpatient ERCP for this subset of patients in the studied context. This is an area worthy of future prospective and multi-center study.
尽管大多数成人 ERCP 是在门诊进行的，但儿科 ERCP 通常是在住院的基础上进行的，或者是在 ERCP 之后至少有一个晚上的住院治疗。我们已经开始在很大程度上将我们的儿科 ERCP 作为门诊手术进行，使用我们的临床判断来指导决策过程。在本研究中，我们比较了门诊和住院 ERCP 与患者特征、适应证和不良事件的关系。
使用我们的内镜数据库，我们确定了 18 岁及以下在 2019 年至 2021 年期间接受 ERCP 的患者。分析了人口统计学、住院状态、适应证、发现、干预措施以及可用的不良事件和临床结果数据。
在研究期间，两位介入内镜医生共进行了 147 例 ERCP 手术。其中有 51 例（34.7%）患者接受了门诊 ERCP。对两组（门诊 vs. 住院 ERCP）的比较发现，患者年龄、适应证范围以及索引与后续 ERCP 的比例无统计学差异。ERCP 相关不良事件的总体发生率较低，门诊与住院 ERCP 患者的不良事件发生率无统计学差异。
我们分析了门诊和住院儿科 ERCP 患者的人口统计学和 ERCP 特征，以确定指导决策的因素，确定是否将儿科 ERCP 作为门诊手术进行。门诊与住院儿科 ERCP 相关不良事件无显著差异，证明在研究背景下，该组患者的门诊 ERCP 是安全的。这是一个值得未来进行前瞻性和多中心研究的领域。
