PMID- 37665426
OWN - NLM
STAT- Publisher
LR  - 20231012
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
VI  - 68
IP  - 11
DP  - 2023 Nov
TI  - Utility of Urgent Endoscopic Retrograde Cholangiopancreatography in Patients with 
      Predicted Mild Acute Pancreatitis and Cholestasis.
PG  - 4259-4265
LID - 10.1007/s10620-023-08004-1 [doi]
AB  - BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) within 72 h is 
      suggested for patients presenting with acute biliary pancreatitis (ABP) and 
      biliary obstruction without cholangitis. This study aimed to identify if urgent 
      ERCP (within 24 h) improved outcomes compared to early ERCP (24-72 h) in patients 
      admitted with predicted mild ABP. METHODS: Patients admitted for predicted mild 
      ABP defined as a bedside index of severity in acute pancreatitis score < 3 and 
      underwent ERCP for biliary obstruction within 72 h of presentation during the 
      study period were included. Patients with prior biliary sphincterotomy or 
      surgically altered anatomy preventing conventional ERCP were excluded. The 
      primary outcome was the development of moderately severe or severe pancreatitis 
      based on the revised Atlanta classification. Secondary outcomes were the length 
      of hospital stay, the need for ICU admission, and ERCP-related adverse events 
      (AEs). RESULTS: Of the identified 166 patients, baseline characteristics were 
      similar between both the groups except for the WBC count (9.4 vs. 8.3/microL; 
      p < 0.044) and serum bilirubin level (3.0 vs. 1.6 mg/dL; p < 0.0039). Biliary 
      cannulation rate and technical success were both high in the overall cohort 
      (98.8%). Urgent ERCP was not associated with increased development of moderately 
      severe pancreatitis (10.4% vs. 15.7%; p = 0.3115). The urgent ERCP group had a 
      significantly shorter length of hospital stay [median 3 (IQR 2-3) vs. 3 days (IQR 
      3-4), p < 0.01]. CONCLUSION: Urgent ERCP did not impact the rate of developing 
      more severe pancreatitis in patients with predicted mild ABP but was associated 
      with a shorter length of hospital stay and a lower rate of hospital readmission.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Kaur, Jyotroop
AU  - Kaur J
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Martin, John A
AU  - Martin JA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Vege, Santhi S
AU  - Vege SS
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Garimella, Vishal
AU  - Garimella V
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Majumder, Shounak
AU  - Majumder S
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Abu Dayyeh, Barham K
AU  - Abu Dayyeh BK
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Storm, Andrew C
AU  - Storm AC
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Vargas, Eric J
AU  - Vargas EJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Law, Ryan J
AU  - Law RJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Bofill, Aliana M
AU  - Bofill AM
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Decker, G Anton
AU  - Decker GA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Petersen, Bret T
AU  - Petersen BT
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA.
FAU - Chandrasekhara, Vinay
AU  - Chandrasekhara V
AUID- ORCID: 0000-0001-6209-9905
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, 
      Rochester, MN, 55905, USA. chandrasekhara.vinay@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20230904
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
SB  - IM
OTO - NOTNLM
OT  - Acute pancreatitis
OT  - Biliary obstruction
OT  - Endoscopic retrograde cholangiopancreatography
OT  - Length of hospital stay
EDAT- 2023/09/04 12:43
MHDA- 2023/09/04 12:43
CRDT- 2023/09/04 11:11
PHST- 2023/01/25 00:00 [received]
PHST- 2023/06/13 00:00 [accepted]
PHST- 2023/09/04 12:43 [pubmed]
PHST- 2023/09/04 12:43 [medline]
PHST- 2023/09/04 11:11 [entrez]
AID - 10.1007/s10620-023-08004-1 [pii]
AID - 10.1007/s10620-023-08004-1 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2023 Nov;68(11):4259-4265. doi: 10.1007/s10620-023-08004-1. Epub 
      2023 Sep 4.