Clinical Study
Therapeutic Endoscopy Can Be Performed Safely in an Ambulatory Surgical Center: A Multicenter, Prospective Study
Table 2
Indications, findings, and interventions 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) |
| Indications | | | | | | | | | | | | | Biliary | | | | | | | | | | | | | Obstructive jaundice | 39 (51%) | 37 (23%) | 76 (32%) | 0.0005 | 10 (46%) | 8 (7%) | 18 (13%) | 0.07 | 49 (50%) | 45 (16%) | 94 (25%) | <0.0001 | SOD | 24 (32%) | 40 (25%) | 64 (27%) | 0.02 | 3 (14%) | 8 (7%) | 11 (8%) | 0.98 | 27 (28%) | 48 (17%) | 75 (20%) | 0.02 | Dilated biliary ductal system | 31 (41%) | 25 (16%) | 56 (24%) | <0.0001 | 4 (18%) | 5 (4%) | 9 (7%) | 0.94 | 35 (36%) | 30 (11%) | 65 (17%) | 0.003 | Choledocholithiasis | 19 (25%) | 22 (14%) | 41 (17%) | 0.046 | 0 | 0 | 0 | 1.00 | 19 (19%) | 22 (8%) | 41 (11%) | 0.55 | Elevated LFT | 17 (20%) | 5 (3%) | 22 (9%) | 0.0002 | 3 (14%) | 1 (1%) | 4 (3%) | 1.00 | 20 (20%) | 6 (2%) | 26 (7%) | 0.004 | Cholangitis | 9 (12%) | 0 | 9 (4%) | 0.92 | 0 | 0 | 0 | 1.00 | 9 (9%) | 10 (3%) | 9 (2%) | 1.00 | Biliary stricture | 3 (4%) | 8 (5%) | 11 (5%) | 0.37 | 1 (5%) | 1 (1%) | 2 (1%) | 0.99 | 4 (4%) | 9 (3%) | 13 (4%) | 0.62 | Stent extraction | 9 (12%) | 28 (18%) | 37 (16%) | 0.12 | 1 (5%) | 0 | 1 (1%) | 0.99 | 10 (10%) | 28 (10%) | 38 (10%) | 0.03 | Bile leak | 10 (13%) | 14 (9%) | 24 (10%) | 0.53 | 1 (5%) | 0 | 1 (1%) | 0.98 | 11 (11%) | 14 (5%) | 25 (7%) | 0.35 | Pancreatic | | | | | | | | | | | | | Pancreatic mass | 8 (11%) | 10 (6%) | 18 (8%) | 0.09 | 6 (27%) | 26 (22%) | 32 (23%) | 0.19 | 14 (14%) | 36 (13%) | 50 (13%) | <0.0001 | Pancreatic cyst | 0 | 6 (4%) | 6 (3%) | 0.96 | 1 (5%) | 38 (33%) | 39 (28%) | 0.22 | 1 (1%) | 44 (16%) | 45 (12%) | <0.0001 | Chronic pancreatitis | 2 (3%) | 16 (10%) | 18 (8%) | 0.11 | 1 (5%) | 8 (7%) | 9 (7%) | 0.37 | 3 (3%) | 24 (9%) | 27 (7%) | 0.48 | Gall stone pancreatitis | 11 (15%) | 1 (1%) | 12 (5%) | 0.003 | 3 (14%) | 3 (3%) | 6 (3%) | 0.02 | 14 (14%) | 4 (1%) | 18 (5%) | 0.009 | Pancreatic divisum | 1 (1%) | 10 (6%) | 11 (5%) | 0.11 | 0 | 2 (2%) | 2 (1%) | 0.99 | 1 (1%) | 14 (5%) | 15 (4%) | 0.44 | Neoplastic | | | | | | | | | | | | | Any neoplasm | 11 (15%) | 12 (8%) | 23 (10%) | 0.10 | 3 (14%) | 29 (25%) | 32 (23%) | 0.61 | 21 (21%) | 44 (16%) | 65 (17%) | <0.0001 | Palliation neoplasm | 5 (7%) | 1 (1%) | 6 (3%) | 0.06 | 2 (9%) | 0 | 2 (1%) | 1.00 | 7 (7%) | 1 (1%) | 8 (2%) | 0.50 | Staging of neoplasm | 6 (8%) | 6 (4%) | 12 (5%) | 0.68 | 5 (23%) | 46 (39%) | 51 (37%) | 0.98 | 11 (11%) | 52 (19%) | 63 (17%) | <0.0001 | Generalized | | | | | | | | | | | | | Chronic abdominal pain | 8 (11%) | 53 (33%) | 61 (26%) | 0.0004 | 0 | 6 (5%) | 6 (3%) | 0.99 | 8 (8%) | 59 (21%) | 67 (18%) | <0.0001 | Intervention | | | | | | | | | | | | | ERCP | | | | | | | | | | | | | Biliary | | | | | | | | | | | | | EBS | 57 (75%) | 108 (68%) | 165 (70%) | <0.0001 | NA | | | 1.00 | 57 (58%) | 108 (39%) | 165 (44%) | <0.0001 | Needle knife | 1 (1%) | 1 (1%) | 2 (1%) | 1.00 | NA | | | 1.00 | 1 (1%) | 1 (1%) | 2 (1%) | 1.00 | SEMS | 12 (16%) | 5 (3%) | 17 (8%) | 0.06 | NA | | | 1.00 | 12 (12%) | 5 (2%) | 17 (5%) | 0.06 | Plastic stent | 23 (30%) | 18 (11%) | 41 (17%) | 0.003 | NA | | | 1.00 | 23 (24%) | 18 (7%) | 41 (11%) | 0.003 | Cytology | 11 (15%) | 22 (14%) | 33 (14%) | 0.0002 | NA | | | 1.00 | 11 (1%) | 22 (8%) | 33 (9%) | 0.0002 | Cholangioscopy | 4 (5%) | 11 (7%) | 15 (11%) | 0.40 | NA | | | 1.00 | 4 (4%) | 11 (4%) | 15 (4%) | 0.40 | Manometry | 2 (3%) | 18 (11%) | 20 (9%) | 0.47 | NA | | | 1.00 | 2 (2%) | 18 (7%) | 20 (5%) | 0.47 | Pancreatic | | | | | | | | | | | | | EPS | 6 (8%) | 30 (19%) | 36 (15%) | 0.03 | NA | | | 1.00 | 6 (6%) | 30 (11%) | 36 (10%) | 0.03 | Minor duct papillotomy | 1 (1%) | 8 (5%) | 9 (4%) | 0.92 | NA | | | 1.00 | 1 (1%) | 8 (3%) | 9 (2%) | 0.92 | PD Stent | 21 (28%) | 44 (28%) | 65 (28%) | 1.00 | NA | | | 1.00 | 21 (21%) | 44 (16%) | 65 (17%) | 0.60 | Ampullary biopsy | 2 (3%) | 13 (8%) | 15 (6%) | 0.13 | 0 | 1 (1%) | 1 (1%) | 1.00 | 3 (3%) | 14 (5%) | 17 (5%) | 0.81 | EUS | | | | | | | | | | | | | FNA | NA | | | 1.00 | 12 (55%) | 77 (66%) | 89 (64%) | <0.0001 | 12 (12%) | 77 (28%) | 89 (24%) | <0.0001 |
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ERCP: endoscopic retrograde cholangiopancreatography; EUS: endoscopic ultrasound; IN: inpatients; ASC: ambulatory surgical center patients; ALL: inpatients + ASC patients; GI: gastrointestinal; LFT: liver function tests; SOD: sphincter of Oddi dysfunction; GIST: gastrointestinal stromal tumor; IPMN: intraductal papillary mucinous neoplasm; NE: neuroendocrine; EBS: endoscopic biliary sphincterotomy; EPS: endoscopic pancreatic sphincterotomy; SEMS: self-expanding metal stent; FNA: fine needle aspiration. Note that is significant.
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