Clinical Study
Therapeutic Endoscopy Can Be Performed Safely in an Ambulatory Surgical Center: A Multicenter, Prospective Study
Table 1
Demographic and risk data for inpatient versus ASC ERCP, EUS, and the total population.
| | | ERCP | EUS | Total | | | IN | ASC | ALL | (95% CI) | IN | ASC | All | (95% CI) | IN | ASC | ALL | (95% CI) |
| | Total cases | 76 | 160 | 236 | | 22 | 117 | 139 | | 98 | 277 | 375 | | | Mean age (years) | 61.8 | 60.2 | 62 | 0.54 | 64.2 | 67.6 | 63.5 | 0.62 | 62.7 | 63.8 | 63.5 | 0.85 | | Sex | | | | | | | | | | | | | | Male | 31 (41%) | 46 (29%) | 77 (33%) | 0.17 | 18 (82%) | 56 (48%) | 74 (53%) | 0.13 | 49 (50%) | 102 (37%) | 151 (40%) | 0.1 | | Female | 45 (59%) | 114 (71%) | 159 (67%) | | 4 (18%) | 61 (52%) | 65 (47%) | | 49 (50%) | 175 (63%) | 224 (60%) | | | Comorbid conditions | | | | | | | | | | | | | | Cardiovascular disease | 35 (46%) | 55 (34%) | 90 (38%) | 0.12 | 4 (18%) | 57 (49%) | 61 (44%) | 0.22 | 39 (40%) | 112 (40%) | 151 (40%) | 0.27 | | Pulmonary disease | 17 (22%) | 18 (11%) | 35 (15%) | 0.04 | 2 (9%) | 17 (15%) | 19 (14%) | 0.53 | 19 (19%) | 35 (13%) | 54 (14%) | 0.97 | | ESRD on dialysis | 12 (16%) | 27 (17%) | 39 (17%) | 0.70 | 1 (5%) | 31 (27%) | 32 (23%) | 0.28 | 16 (16%) | 62 (22%) | 78 (21%) | 0.03 | | Cirrhosis | 5 (7%) | 7 (4%) | 12 (5%) | 0.53 | 0 | 5 (4%) | 5 (4%) | 0.99 | 5 (5%) | 13 (5%) | 18 (5%) | 0.98 | | Medications | | | | | | | | | | | | | | Anticoagulation | 3 (4%) | 6 (4%) | 9 (4%) | 1.00 | 1 (5%) | 4 (3%) | 5 (4%) | 0.28 | 4 (4%) | 10 (4%) | 14 (4%) | 0.55 | | Antiplatelet agent | 16 (21%) | 23 (14%) | 39 (17%) | 0.25 | 1 (5%) | 25 (2%) | 26 (19%) | 0.43 | 17 (17%) | 48 (17%) | 65 (17%) | 0.07 | | Endoscopic risk factors | | | | | | | | | | | | | | High risk features | 17 (22%) | 69 (43%) | 86 (36%) | 0.09 | 0 | 6 (5%) | 6 (4%) | 0.99 | 17 (17%) | 75 (27%) | 92 (25%) | 0.1 | | History of SOD | 4 (5%) | 19 (12%) | 23 (10%) | 0.09 | 0 | 6 (5%) | 6 (4%) | 1.00 | 4 (4%) | 25 (7%) | 29 (6%) | 0.72 | | History of post-ERCP pancreatitis | 0 | 0 | 0 | 1.00 | 0 | 0 | 0 | 1.00 | 0 | 0 | 0 | 1.00 | | Pancreatic sphincterotomy | 7 (9%) | 37 (23%) | 44 (19%) | 0.03 | NA | | | 1.00 | 7 (7%) | 37 (13%) | 44 (12%) | 0.01 | | Precut sphincterotomy | 1 (1%) | 1 (1%) | 2 (1%) | 0.62 | NA | | | 1.00 | 1 (1%) | 1 (1%) | 2 (1%) | 1.00 | | >8 cannulation attempts | 0 | 0 | 0 | 1.00 | NA | | | 1.00 | 0 | 0 | 0 | 1.00 | | Pneumatic dilation of an intact biliary sphincter | 5 (7%) | 9 (6%) | 14 (6%) | 0.84 | NA | | | 1.00 | 5 (5%) | 9 (3%) | 14 (4%) | 1.00 | | Ampullectomy | 0 | 3 (2%) | 3 (1%) | 0.95 | NA | | | 1.00 | 0 | 3 (1.1%) | 3 (0.8%) | 1.00 | | Moderate risk features | 19 (25%) | 68 (43%) | 87 (37%) | 0.10 | 0 | 7 (6%) | 7 (5%) | 0.98 | 19 (19%) | 75 (27%) | 94 (25%) | 0.02 | | Age < 50 and female | 9 (12%) | 26 (16%) | 35 (15%) | 0.29 | 0 | 3 (3%) | 3 (2%) | 0.99 | 9 (9%) | 29 (11%) | 38 (10%) | 0.09 | | History of recurrent pancreatitis | 6 (8%) | 7 (4%) | 13 (6%) | 0.38 | 0 | 4 (3%) | 4 (3%) | 0.99 | 6 (6%) | 11 (4%) | 17 (5%) | 0.93 | | >3 injections to PD, 1 to tail | 1 (1%) | 11 (7%) | 12 (5%) | 1.00 | NA | | | 1.00 | 1 (1%) | 11 (4%) | 12 (3%) | 1.00 | | Excessive injection PD contrast, leading to acini | 0 | 0 | 0 | 1.00 | NA | | | 1.00 | 0 | 0 | 0 | 1.00 | | Acquisition of cytology from PD using brush | 3 (4%) | 5 (3%) | 8 (3%) | 0.30 | NA | | | 1.00 | 3 (3%) | 5 (2%) | 8 (2%) | 0.30 | | Anesthesia risk | | | | | | | | | | | | | | Mean Mallampati score | 1.7 | 1.4 | 1.5 | 0.09 | 1.6 | 1.5 | 1.5 | 0.93 | 1.7 | 1.5 | 1.5 | 0.02 | | Mean ASA score | 2.8 | 2.3 | 2.5 | 0.12 | 2.8 | 2.6 | 2.6 | 0.38 | 2.8 | 2.4 | 2.5 | 0.24 | | 1 | 2 (3%) | 17 (11%) | 19 (8%) | | 0 | 1 (1%) | 1 (1%) | | 2 (2%) | 18 (7%) | 20 (5%) | | | 2 | 17 (22%) | 74 (46%) | 91 (39%) | | 4 (18%) | 45 (39%) | 49 (35%) | | 21 (21%) | 119 (43%) | 140 (37%) | | | 3 | 52 (68%) | 69 (43%) | 121 (51%) | | 18 (82%) | 71 (61%) | 89 (64%) | | 70 (71%) | 140 (51%) | 210 (56%) | | | 4 | 5 (7%) | 0 | 5 (2%) | | 0 | 0 | 0 | | 5 (5%) | 0 | 5 (1%) | |
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ERCP: endoscopic retrograde cholangiopancreatography; EUS: endoscopic ultrasound; IN: inpatients; ASC: ambulatory surgical center patients; ALL: inpatients + ASC patients; CI: confidence interval; ESRD: end-stage renal disease; SOD: sphincter of Oddi dysfunction; PD: pancreatic duct; ASA: American society of anesthesia class.
Note that is significant.
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