A prospective study of the safety of endoscopic therapy for choledocholithiasis in an outpatient population.
OBJECTIVE
Many centers routinely admit patients for observation after endoscopic therapy of choledocholithiasis although this is contrary to the current mandate for cost containment. The purpose of this study was to determine the safety, success, and complication rates of outpatient therapeutic ERCP in the management of choledocholithiasis.


METHODS
Over a 4-month period, 97 consecutive outpatients undergoing endoscopic treatment for choledocholithiasis were enrolled in a prospective manner. Each subject was observed 1-3 h postprocedure before discharge with follow-up at 10 days.


RESULTS
Successful endoscopic management of choledocholithiasis was achieved in 100% of patients. Complication rates were as follows: pancreatitis (2.1%), postsphincterotomy bleeding (3.2%), perforation (0%), and sepsis (0%). One patient required admission during the observation period, and two others with pancreatitis were readmitted within 24 h of discharge. There was no apparent adverse clinical outcome related to this policy.


CONCLUSIONS
Endoscopic therapy of choledocholithiasis may be performed safely on an outpatient basis, realizing significant cost savings.
Elfant
A B
AB
Centre for Therapeutic Endoscopy and Endoscopic Oncology, Wellesley Hospital, University of Toronto, Ontario, Canada.
Bourke
M J
MJ
Alhalel
R
R
Kortan
P P
PP
Haber
G B
GB
D000556:Ambulatory Surgical Procedures / Q000191:economics; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003363:Cost Control; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012449:Safety; D016717:Sphincterotomy, Endoscopic / Q000191:economics / Q000379:methods*; D013997:Time Factors