Duration of ERCP

has been shown to be a determinant of cardio-respiratory complications. The relationship between ERCP duration, indications and procedure related complications are less clear. Aim: To determine if longer ERCP duration is associated with a greater risk of complications particularly post ERCP pancreatitis and to explore the relationship between indications for ERCP and its duration. Patient and Methods: Data were retrieved from a prospective database of 1305 ERCPs performed in a tertiary referral centre. In BMS-777607 solubility dmso every case, the endoscopist contemporaneously measured ERCP duration, which was the time from the scope breaching the cricopharyngeus to its withdrawal PLX3397 mouse from the patient.

Indications for ERCP included acute pancreatitis (AP), bile leak (BL), cholangitis (CH), change of stent for benign conditions (C/ROSB), change of stent for malignant conditions (C/ROSM), stone seen at intraoperative cholangiogram (IOC), combination of biliary pain, imaging evidence of bile duct abnormality, deranged liver function tests (PIL) and other (O). Complications examined included development of post ERCP pancreatitis (PEP) and unplanned hospitalization or prolongation of hospital stay following ERCP. Results: A total of 1305 procedures, which were performed by a single interventional endoscopist, were analyzed. Indications for ERCP were AP (n = 160), BL (n = 27), CH (n = 115), C/ROSB (n = 196), C/ROSM (n = 46), IOC (n = 98), PIL (n = 626) and O (n = 37). The average procedure

duration was 24 minutes (SD 13.7). Emergent procedures took longer (34.5 mins) than the non-emergent procedures (23.5 minutes) p < 0.001. ERCP for bile leak took longer (31.90 mins, SE 2.91) than procedures for other indications, which averaged between 21 to 25 mins (p < 0.001, ANOVA). Using a generalized linear model adjusting for the presence GNAT2 of a previous sphincterotomy and whether the procedure was emergent or not, the indication for ERCP remained a statistically significant predictor of procedure time. The overall risk of PEP was 4.4% (58 patients). As compared with a duration time of less than 18 mins, procedures exceeding 34 minutes were associated with a 3-fold increase in the risk of PEP (2.2% versus 6.6% p < 0.005) and increased rates of unplanned hospitalization or prolongation of hospital stay (8% versus 14.7%, p = 0.026). Using logistic regression model adjusting for previous sphincterotomy, the incidence of pancreatitis was noted to be higher in PIL and AP versus the other groups (5.60% vs 2.30%, p = 0.009), OR 2.25 (CI 1.2, 5.0).