ERCP as an outpatient treatment: a review

ERCP on an outpatient basis could be as safe as on an inpatient basis and may also reduce medical costs.

To review the available literature to determine the safety of an ERCP performed on an outpatient basis.

A review of the published literature was performed by searching PubMed, the Cochrane Library, EMBASE, and the Web of Science.

Patients who were undergoing an ERCP.

An ERCP on an inpatient or outpatient basis.

Patient and treatment characteristics, complications, and prolonged hospital admissions and readmissions.

Eleven 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.

Limited data available.

This review shows that, with a selective policy, an ERCP on an outpatient basis seems as safe as when performed on an inpatient basis.