title: Is outpatient ERCP suitable, feasible, and safe? The experience of a Spanish community hospital.
abstract: BACKGROUND
  We wanted to evaluate the safety of outpatient endoscopic retrograde cholangiopancreatography (ERCP). The follow-up of an ERCP outpatient during a short observation period could be a feasible and safe approach.
  
  
  METHODS
  To evaluate the safety of outpatient ERCP, we assessed the rate of post-ERCP complications found and missed during a 6-h observation period after therapeutic ERCP.
  
  
  RESULTS
  We performed 236 ERCPs on an outpatient basis, with a failure rate of 3.7% but with an overall completion rate for the intended treatment of 90.7%. Seventy-eight percent of the ERCPs were primarily therapeutic. The age of the patients was 63.9 years and 61.9% were females. One hundred seventy-seven (74.5%) patients were discharged from the hospital after the observation period. Thirty-three (14.1%) patients were admitted without further delay due to unexpected ERCP findings or for early detection of complications. Twenty-seven (11.4%) patients had a prolonged hospital stay because of complications during the observation period. Just two patients previously discharged developed later complications: cholangitis and pancreatitis (0.84% of the ERCPs and 7.4% of the overall complications). There were 27 ERCP complications (12.1%). Of the overall complications, 29.6% were diagnosed very early after the procedure and 62.9% were diagnosed during the observation period. 8.9% out of the 12.1% of the ERCP complications were mild to moderate. There was no mortality.
  
  
  CONCLUSIONS
  Twenty-five (92.6%) of ERCP complications occurred during the first 6 h, making the use of this short observation period safe for an early discharge. The evolution of the patients who developed delayed complications was unremarkable. Whenever outpatient ERCP is feasible, it should be done to help cut costs.
authors.affiliation: Department of Gastroenterology, Hospital Severo Ochoa (Leganés), Madrid, Spain. lrabagot@gmail.com
authors.forename: Luís
authors.initials: L
authors.lastname: Rábago
authors.forename: Ivan
authors.initials: I
authors.lastname: Guerra
authors.forename: Marta
authors.initials: M
authors.lastname: Moran
authors.forename: Elvira
authors.initials: E
authors.lastname: Quintanilla
authors.forename: David
authors.initials: D
authors.lastname: Collado
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Chico
authors.forename: Ana
authors.initials: A
authors.lastname: Olivares
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Castro
authors.forename: Francisco
authors.initials: F
authors.lastname: Gea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D004066:Digestive System Diseases / Q000175:diagnosis* / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult