A prospective series of out-patient endoscopic retrograde cholangiopancreatography

Objective Out-patient endoscopic retrograde cholangiopancreatography (ERCP) is widely practised but the safety of this approach has only been addresse d in a limited number of prospective series mainly from specialist North Am erican centres. Our objective was to determine prospectively the safety and admission rates of out-patient ERCPs. Study design and participants Patients were selected for out-patient ERCP i f in relatively good health, without major risk factors for complications f ollowing ERCP and with adequate social support. Our series consisted of 136 consecutive cases of which 82 were therapeutic. Setting and outcome measures A district general hospital in the UK, which a lso performs ERCPs for neighbouring health districts. Out-patient ERCP pati ents were followed up at 30 days using standard criteria for defining compl ications. Results Procedures were 60 biliary sphincterotomy, 10 stone removal, nine s tenting procedures, two dilatations and one pancreatic intervention. Compli cations were pancreatitis in seven patients (six moderate severity, one mil d), cholangitis in three patients, haemorrhage in one patient. Nine patient s required admission for complications, two from the endoscopy unit and sev en from home; their average in-patient stay was 6 days. Seventeen patients were admitted for observation or for further management. There was one deat h unrelated to ERCP. Overall, 110 of 136 patients did not require inpatient care following out-patient ERCP. Conclusions Our complication rates were similar to those of other series. O ut-patient ERCP for selected cases, with adequate post-discharge arrangemen ts for advice and readmission, appears safe and would reduce healthcare cos ts. (C) 2000 Lippincott Williams & Wilkins.