Trends in same-admission cholecystectomy and endoscopic retrograde cholangiopancreatography for acute gallstone pancreatitis: A nationwide analysis across a decade

Bilal, Mohammad; Kline, Kevin; Trieu, Judy A.; Saraireh, Hamzeh; Desai, Madhav; Parupudi, Sreeram; Abougergi, Marwan S.

doi:10.1016/j.pan.2019.04.008

Cited by 28 publications

(20 citation statements)

References 20 publications

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“…Even though choledocholithiasis remains the most common indication for ERCP, the proportion of ERCP in patients with acute biliary pancreatitis has decreased. This is expected and consistent with other recent studies, since consensus guidelines recommend that ERCP should only be performed in acute biliary pancreatitis patients if they have cholangitis or have documented or increased suspicion of choledocholithiasis [21,22]. Interestingly, our analysis showed that a greater number of ERCPs are being performed for cholangitis now as compared to 10 years ago.…”

Section: Unadjustedsupporting

confidence: 92%

Use of ERCP in the United States over the past decade

et al. 2020

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Background and study aims With newer imaging modalities, indications for use of endoscopic retrograde cholangiopancreatography (ERCP) have changed in the last decade. Despite advances in ERCP, paucity in recent literature regarding utilization and outcomes of ERCP exists. Thus, the aim of this study was to assess the inpatient use of ERCP, outcomes, and most common indications. Patients and methods Retrospective-cohort study using the Nationwide Inpatient Sample 2007–2016. All patients with ICD9–10CM procedural codes for ERCP were included. The primary outcome was the use of ERCP. Secondary outcomes included determining procedural specifics (stenting, sphincterotomy and dilation), complications (post-ERCP pancreatitis [PEP], bile duct perforation), hospital length of stay, total hospital costs and charges. Multivariate regression analysis was used to adjust for confounders. Results A total of 1,606,850 patients underwent inpatient ERCP. The mean age was 59 years (60 % female). The total number of ERCPs increased over the last decade. Patients undergoing ERCP in 2016 had greater odds of undergoing bile duct stent placement, pancreatic duct (PD) stenting, biliary dilation, pancreatic sphincterotomy, PEP and biliary perforation. Inpatient mortality decreased. Hospital charges increased, while length of stay (LOS) decreased. Conclusions The number of ERCPs increased in the past decade. Odds of therapeutic interventions and complications increased. The most common principal diagnoses were choledocholithiasis and gallstone-related AP. Hence, physicians must be aware to promptly diagnose and treat complications. These findings may reflect the increased case complexity and fact that ERCP continues to evolve into an increasingly interventional tool, contrasting from its former role as a predominantly diagnostic and gallstone extraction tool.

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Section: Unadjustedsupporting

confidence: 92%

Use of ERCP in the United States over the past decade

et al. 2020

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“…Although our results revealed an increase in acute pancreatitis' incident cases during the 30-year study period, the mortality rate declined continuously. We have also observed a decreasing mortality rate over the last decade [8,[27][28][29][30]. These outcomes are justifiable, for patients with acute pancreatitis are becoming easier to identify with better testing approaches, and the complications can be detected at an earlier stage in the disease course [31].…”

Section: Discussionmentioning

confidence: 98%

“…Global efforts using appropriate preventive and treatment approaches to reduce the morbidity and mortality of acute pancreatitis require timely information about the burden and their risk factors. However, the current analyses on the epidemiology of acute pancreatitis were based exclusively on limited local data [1,[8][9][10][11][12][13][14][15], which inevitably subjected to selection bias and could not describe the disease burden around the globe in a robust manner. The Global Burden of Disease study (GBD), with its broad collection of data sources and the state-of-the-art statistical modelling approaches [16][17][18] provides us a unique opportunity to deliver the most comprehensive estimates of acute pancreatitis' burden to date.…”

Section: Introductionmentioning

confidence: 99%

The global, regional, and national burden of acute pancreatitis in 204 countries and territories, 1990–2019

Jiang

Pan

et al. 2021

BMC Gastroenterol

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Background Acute pancreatitis is a common and potentially lethal gastrointestinal disease, but literatures for the disease burden are scarce for many countries. Understanding the current burden of acute pancreatitis and the different trends across various countries is essential for formulating effective preventive intervenes. We aimed to report the incidence, mortality, and disability-adjusted life-years (DALYs) caused by acute pancreatitis in 204 countries and territories between 1990 and 2019. Methods Estimates from the Global Burden of Disease Study 2019 (GBD 2019) were used to analyze the epidemiology of acute pancreatitis at the global, regional, and national levels. We also reported the correlation between development status and acute pancreatitis’ age-standardized DALY rates, and calculated DALYs attributable to alcohol etiology that had evidence of causation with acute pancreatitis. All of the estimates were shown as counts and age-standardized rates per 100,000 person-years. Results There were 2,814,972.3 (95% UI 2,414,361.3–3,293,591.8) incident cases of acute pancreatitis occurred in 2019 globally; 1,273,955.2 (1,098,304.6–1,478,594.1) in women and 1,541,017.1 (1,307,264.4–1,814,454.3) in men. The global age-standardized incidence rate declined from 37.9/100,000 to 34.8/100,000 during 1990–2019, an annual decrease of 8.4% (5.9–10.4%). In 2019, there were 115,053.2 (104,304.4–128,173.4) deaths and 3,641,105.7 (3,282,952.5–4,026,948.1) DALYs due to acute pancreatitis. The global age-standardized mortality rate decreased by 17.2% (6.6–27.1%) annually from 1.7/100,000 in 1990 to 1.4/100,000 in 2019; over the same period, the age-standardized DALY rate declined by 17.6% (7.8–27.0%) annually. There were substantial differences in the incidence, mortality and DALYs across regions. Alcohol etiology attributed to a sizable fraction of acute pancreatitis-related deaths, especially in the high and high-middle SDI regions. Conclusion Substantial variation existed in the burden of acute pancreatitis worldwide, and the overall burden remains high with aging population. Geographically targeted considerations are needed to tailor future intervenes to relieve the burden of acute pancreatitis in specific countries, especially for Eastern Europe.

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“…This fact improved their RABP rate (5 % vs 20 %), and when the reasons why no surgery had been carried out were investigated, surprisingly, up to 22 % of their patients had not even been referred to a surgeon. On the other hand, in the national American study by Bial et al (24), same-admission cholecystectomy rates in the USA have worsened over time: 48.7 % in 2004 and 46.9 % in 2009, decreasing further down to 45 % in 2014, with no parallel increase in sphincterotomies. These authors blame delayed cholecystectomy on attempts at shortening hospital stays to deceitfully reduce admission-associated costs even at the risk of future readmissions, which would ultimately raise health care expenses.…”

mentioning

confidence: 95%

Recurrent acute biliary pancreatitis � A frequent and preventable condition potentially associated with morbidity and mortality

Rebollo¹

2022

Rev Esp Enferm Dig

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Trends in same-admission cholecystectomy and endoscopic retrograde cholangiopancreatography for acute gallstone pancreatitis: A nationwide analysis across a decade

Cited by 28 publications

References 20 publications

Use of ERCP in the United States over the past decade

Use of ERCP in the United States over the past decade

The global, regional, and national burden of acute pancreatitis in 204 countries and territories, 1990–2019

Recurrent acute biliary pancreatitis � A frequent and preventable condition potentially associated with morbidity and mortality

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