[Endoscopic sphincterotomy as an out-patient procedure: is it safe?].

BACKGROUND

Patients have been routinely admitted for observation for potential complications after therapeutic ERCP; however, in this era of cost containment it may be more cost-effective to perform these procedures on an out-patient basis.

AIM: The purpose of this study was to determine safety and complication rates of endoscopic sphincterotomy in out-patients.

MATERIALS AND PATIENTS: Over an 11-month period, 124 consecutive patient undergoing endoscopic sphincterotomy for biliary and pancreatic disease were enrolled in a prospective and randomized manner. Sixty patients (Group A) were observed 1-3 h post procedure before discharge with follow-up at 5 days. The other 62 patients (Group B) were admitted for observation. The statistical method was Fisher test and chi 2.

RESULTS

Successful endoscopic sphincterotomy was achieved in 98.3% (122/124) of patients. Eighty five patients were female and 37 male. There were 60 outpatients and 62 in-patients; endoscopic sphincterotomy was performed by choledocholithiasis in 59.9% (70 cases) and papillary stenoses in 16.4% (20 cases). Complication rates were 3.27% (four patients): three pancreatitis and one bleeding. There were three in-patients and one outpatient (p. 313). We reduce costs $324,120.00 M.N. (Mexican pesos) without compromising patient safety and outcome.

CONCLUSIONS

Endoscopic sphincterotomy may be performed safely on an outpatient basis, realizing significant savings in costs.