P4456 - Comparison of Inpatient versus Outpatient Endoscopic Retrograde Cholangiopancreatography (ERCP) Outcomes in a Community Hospital System

Rahul Patel, DO¹, Hiral Amin, DO¹, Shashank Gupta, DO¹, Sachin Prasad, DO¹, Kristine Wong, DO¹, Tirth Patel, PhD², Marisa Pope, DO¹, C. Jonathan Foster, DO^3
1Jefferson Health, Washington Township, NJ; ²Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ; ³Jefferson Health, Cherry Hill, NJ

Introduction: Endoscopic Retrograde Cholangiopancreatography (ERCP) performed in both the inpatient or outpatient setting has been shown to be safe. Both urgent and emergent cases of ERCP arise in the inpatient setting. Conversely, outpatient ERCPs occur in a more controlled setting. It is important to quantify efficacy and safety of both inpatient and outpatient ERCPs to aid in reduction of hospital length of stay (LOS) while minimizing operative complications. In this retrospective study we aim to identify if the operative setting correlates with higher complication rates.



Methods: A retrospective chart review was performed to compare patient outcomes whilst undergoing ERCP in the inpatient and outpatient setting in a 3 center community hospital system. Data collected was age, race, ethnicity, gender, and procedure duration (minutes). The collected data was compared inpatient, outpatient and combined to observe the complications of pancreatitis and ileus.

Results: 983 patients undergoing ERCP in the inpatient and outpatient setting were included in this study with 619 and 364 patients in each respective group. The average age was 65.27 and 64.04 years for inpatient and outpatient patients respectively with no significant difference (p >0.05). Procedure time was 31.66 and 27.71 minutes for inpatient and outpatient respectively which was significantly different (p< 0.05) between the groups. Pancreatitis was observed in 0.018% and 0.019% in the inpatient and outpatient setting respectively with a Pearson Chi squared and likelihood ratio p-value of >0.05 indicating no significant difference in occurrence. Ileus was observed in 0.03% and 0.003% of patients in the inpatient and outpatient setting respectively with a Pearson Chi squared and likelihood ratio p-value > 0.05 indicating no significant difference.

Discussion: This study aims to compare the complication rate and average procedure length between ERCPs done in the inpatient and outpatient settings. Common complications of ERCP include pancreatitis and ileus that occurred in both inpatient and outpatient cases without any significant difference. Despite a similar rate of complication, average procedure time was significantly lower in the outpatient setting. Further studies are needed to elucidate whether these similarities in complication rates apply to larger populations and if lower procedure times correlate with pathologic complexity.


Disclosures:


Rahul Patel, DO¹, Hiral Amin, DO¹, Shashank Gupta, DO¹, Sachin Prasad, DO¹, Kristine Wong, DO¹, Tirth Patel, PhD², Marisa Pope, DO¹, C. Jonathan Foster, DO³. P4456 - Comparison of Inpatient versus Outpatient Endoscopic Retrograde Cholangiopancreatography (ERCP) Outcomes in a Community Hospital System, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.