Early Endoscopic Retrograde Cholangiopancreatography in Gallstone Pancreatitis Is Safe: Results From a Large Single-Center Retrospective Study.

Autor:	Maloof T; From the Department of Medicine, Northwestern University Feinberg School of Medicine., Rodrigues D; Northwestern University Feinberg School of Medicine., Li T; Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine., Rodrigues T; Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine., Lancki N; Division of Biostatistics, Northwestern University Feinberg School of Medicine, Chicago, IL., Keswani RN; Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine.
Jazyk:	angličtina
Zdroj:	Pancreas [Pancreas] 2024 Sep 01; Vol. 53 (8), pp. e657-e661. Date of Electronic Publication: 2024 May 01.
DOI:	10.1097/MPA.0000000000002352
Abstrakt:	Objectives: There is concern that performing early endoscopic retrograde cholangiopancreatography (ERCP) in the setting of gallstone pancreatitis (GSP) with choledocholithiasis can worsen underlying pancreatitis. This study was designed to assess outcomes of early versus delayed ERCP in patients with GSP with choledocholithiasis in the absence of cholangitis. Materials and Methods: In this single-center retrospective study, we identified 124 patients who underwent ERCP for choledocholithiasis in the setting of GSP without cholangitis between 2012 and 2022. Timing of ERCP was categorized as early (<48 hours after time of diagnosis) versus delayed (>48 hours). Data on patient demographics, complications, length of stay (LOS), and mortality were collected. Results: Cannulation success rates were similar for early and delayed ERCP (97% vs 100%). The adverse event rate for early ERCP was 15% compared to 29% for delayed ERCP. LOS for patients with predicted mild pancreatitis was shorter for early versus delayed ERCP (4.2 vs 7.1 days, P = 0.007). There were no deaths in either group. Conclusions: There was a trend toward fewer adverse events and there was a shorter LOS among patients with GSP with choledocholithiasis undergoing early versus delayed ERCP. Early ERCP should be considered, particularly in patients with predicted mild pancreatitis. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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