CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(06): E761-E769
DOI: 10.1055/a-1134-4873
Original article

Use of ERCP in the United States over the past decade

Paul T. Kröner
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States
,
Mohammad Bilal
2   Division of Gastroenterology and Hepatology Beth Israel Deaconess Medical Center, Boston, Massachusetts, United State
,
Ronald Samuel
3   Department of Internal Medicine, The University of Texas Medical Branch, Galveston, Texas, United States
,
Shifa Umar
4   Division of Gastroenterology, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
,
Marwan S. Abougergi
5   Division of Gastroenterology, Palmetto Health, Columbia, South Carolina, United States
,
Frank J. Lukens
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States
,
Massimo Raimondo
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States
,
David L. Carr-Locke
6   Division of Gastroenterology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, United States
› Author Affiliations

Abstract

Background and study aims With newer imaging modalities, indications for use of endoscopic retrograde cholangiopancreatography (ERCP) have changed in the last decade. Despite advances in ERCP, paucity in recent literature regarding utilization and outcomes of ERCP exists. Thus, the aim of this study was to assess the inpatient use of ERCP, outcomes, and most common indications.

Patients and methods Retrospective-cohort study using the Nationwide Inpatient Sample 2007–2016. All patients with ICD9–10CM procedural codes for ERCP were included. The primary outcome was the use of ERCP. Secondary outcomes included determining procedural specifics (stenting, sphincterotomy and dilation), complications (post-ERCP pancreatitis [PEP], bile duct perforation), hospital length of stay, total hospital costs and charges. Multivariate regression analysis was used to adjust for confounders.

Results A total of 1,606,850 patients underwent inpatient ERCP. The mean age was 59 years (60 % female). The total number of ERCPs increased over the last decade. Patients undergoing ERCP in 2016 had greater odds of undergoing bile duct stent placement, pancreatic duct (PD) stenting, biliary dilation, pancreatic sphincterotomy, PEP and biliary perforation. Inpatient mortality decreased. Hospital charges increased, while length of stay (LOS) decreased.

Conclusions The number of ERCPs increased in the past decade. Odds of therapeutic interventions and complications increased. The most common principal diagnoses were choledocholithiasis and gallstone-related AP. Hence, physicians must be aware to promptly diagnose and treat complications. These findings may reflect the increased case complexity and fact that ERCP continues to evolve into an increasingly interventional tool, contrasting from its former role as a predominantly diagnostic and gallstone extraction tool.



Publication History

Received: 26 September 2019

Accepted: 12 February 2020

Article published online:
25 May 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

 
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