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ERCP improves mortality in acute biliary pancreatitis without cholangitis.

Aleksey A Novikov1, Jennifer H Fieber2, Monica Saumoy3

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Early endoscopic retrograde cholangiopancreatography (ERCP) during hospitalization for acute gallstone pancreatitis without cholangitis (AGPNC) is associated with reduced mortality. Shorter wait times for ERCP also correlate with shorter hospital stays for these patients.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Surgical Gastroenterology

Background:

  • Acute pancreatitis (AP) is a common cause of hospitalization in the US.
  • The role and timing of ERCP in acute gallstone pancreatitis without cholangitis (AGPNC) remain debated.
  • This study investigates ERCP's impact on mortality and length of stay in AGPNC patients.

Purpose of the Study:

  • To evaluate the association between ERCP during admission and mortality in AGPNC patients.
  • To assess the impact of ERCP timing on mortality and length of stay (LOS) in AGPNC.
  • To determine if early ERCP improves outcomes for AGPNC.

Main Methods:

  • Analysis of Nationwide Inpatient Sample (NIS) data from 2004-2014.
  • Inclusion of patients with gallstone AP, excluding chronic pancreatitis or cholangitis.
  • Primary outcomes: inpatient mortality and hospital LOS.

Main Results:

  • 30.6% of analyzed AP patients had AGPNC (150,101 patients).
  • ERCP during admission was linked to a 43% reduction in mortality.
  • ERCP between Days 3-9 showed significant mortality benefit; shorter wait times correlated with shorter LOS.

Conclusions:

  • Inpatient ERCP for AGPNC is associated with decreased mortality.
  • These findings support the early use of ERCP in AGPNC management.
  • Timely ERCP may reduce hospital LOS in AGPNC patients.