title: Outcome of emergency ERCP in the intensive care unit.
abstract: There are limited data on the outcome of emergency endoscopic retrograde cholangiopancreatography (ERCP) performed in the intensive care unit (ICU). We sought to assess the frequency, indications, and clinical outcomes of ERCPs performed in ICU patients who were too unstable to be transported to the endoscopy unit. An electronic endoscopy database was used to identify the patients (n = 22) and to assess procedural success, complications, and mortality. The indications for ERCP included suspected biliary sepsis, suspected gallstone pancreatitis, and known choledocholithiasis with cholangitis. Biliary cannulation, which was attempted in all patients, was successful in 19 patients (86 %), and of these 18 (95 %) underwent a technically successful endoscopic therapy. There were no apparent endoscopic complications. Therefore, emergency bedside ERCP in ICU patients, which is primarily performed for the management of suspected biliary sepsis and gallstone pancreatitis, can achieve high technical success rates when performed by experienced endoscopists, although the 30-day mortality rate remains high due to multiorgan dysfunction.
authors.affiliation: Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: A
authors.initials: A
authors.lastname: Saleem
authors.forename: C J
authors.initials: CJ
authors.lastname: Gostout
authors.forename: B T
authors.initials: BT
authors.lastname: Petersen
authors.forename: M D
authors.initials: MD
authors.lastname: Topazian
authors.forename: O
authors.initials: O
authors.lastname: Gajic
authors.forename: T H
authors.initials: TH
authors.lastname: Baron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000175:diagnosis* / Q000601:surgery; D002779:Cholestasis / Q000175:diagnosis* / Q000601:surgery; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000601:surgery; D016638:Critical Illness; D004630:Emergencies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome