Eunae Cho, Se Woo Park, Kyong Joo Lee, Da Hae Park, Hyewon Cha, Dong Hee Koh, Jin Lee, Chan Hyuk Park
{"title":"周末内窥镜逆行胆管造影仅引流策略对手术相关不良事件风险的影响：一项前瞻性观察研究。","authors":"Eunae Cho, Se Woo Park, Kyong Joo Lee, Da Hae Park, Hyewon Cha, Dong Hee Koh, Jin Lee, Chan Hyuk Park","doi":"10.1177/17562848251361694","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The feasibility of performing complete endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis during weekends or holidays remains controversial due to concerns over increased risks of adverse events (AEs) in off-hour procedures.</p><p><strong>Objectives: </strong>To evaluate whether weekend drainage-only ERCP affects the incidence of AEs compared to standard weekday ERCP, and to identify risk factors for post-ERCP pancreatitis (PEP).</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>Patients with acute cholangitis, diagnosed based on the Tokyo Guidelines 2018 and naïve major papillae, were prospectively enrolled between 2018 and 2023. Patients were categorized into two groups: the \"Weekend ERCP\" group, in which initial biliary drainage was performed on weekends with subsequent therapeutic ERCP on weekdays, and the \"Weekday ERCP\" group, in which all procedures were completed during weekdays. The primary outcome was the incidence of PEP; secondary outcomes included overall AEs and risk factor analysis.</p><p><strong>Results: </strong>A total of 1772 patients were included (Weekend group: <i>n</i> = 148; Weekday group: <i>n</i> = 1624) in this study. The incidence of PEP was 4.1% in the Weekend group and 4.9% in the Weekday group (<i>p</i> = 0.810). Overall AEs occurred in 3.4% and 4.9% of patients, respectively (<i>p</i> = 0.540). Multivariable analysis identified age ⩽60 years, female sex, history of acute pancreatitis, difficult cannulation, and endoscopic papillary balloon dilation as independent risk factors for PEP. Timing of ERCP (weekend vs weekday) was not associated with increased risk of PEP.</p><p><strong>Conclusion: </strong>Weekend ERCPs limited to drainage-only strategies are as safe as weekday procedures in terms of AE rates, effectively managing resources and providing timely biliary decompression for acute cholangitis emergencies, although they often require subsequent definitive interventions.</p><p><strong>Trial registration: </strong>The International Clinical Trials Registry Platform (identifier KCT0005950; https://cris.nih.go.kr).</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251361694"},"PeriodicalIF":3.4000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357021/pdf/","citationCount":"0","resultStr":"{\"title\":\"Drainage-only strategy on weekend for endoscopic retrograde cholangiopancreatography on the risk of procedure-related adverse events: a prospective observational study.\",\"authors\":\"Eunae Cho, Se Woo Park, Kyong Joo Lee, Da Hae Park, Hyewon Cha, Dong Hee Koh, Jin Lee, Chan Hyuk Park\",\"doi\":\"10.1177/17562848251361694\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The feasibility of performing complete endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis during weekends or holidays remains controversial due to concerns over increased risks of adverse events (AEs) in off-hour procedures.</p><p><strong>Objectives: </strong>To evaluate whether weekend drainage-only ERCP affects the incidence of AEs compared to standard weekday ERCP, and to identify risk factors for post-ERCP pancreatitis (PEP).</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>Patients with acute cholangitis, diagnosed based on the Tokyo Guidelines 2018 and naïve major papillae, were prospectively enrolled between 2018 and 2023. Patients were categorized into two groups: the \\\"Weekend ERCP\\\" group, in which initial biliary drainage was performed on weekends with subsequent therapeutic ERCP on weekdays, and the \\\"Weekday ERCP\\\" group, in which all procedures were completed during weekdays. The primary outcome was the incidence of PEP; secondary outcomes included overall AEs and risk factor analysis.</p><p><strong>Results: </strong>A total of 1772 patients were included (Weekend group: <i>n</i> = 148; Weekday group: <i>n</i> = 1624) in this study. The incidence of PEP was 4.1% in the Weekend group and 4.9% in the Weekday group (<i>p</i> = 0.810). Overall AEs occurred in 3.4% and 4.9% of patients, respectively (<i>p</i> = 0.540). Multivariable analysis identified age ⩽60 years, female sex, history of acute pancreatitis, difficult cannulation, and endoscopic papillary balloon dilation as independent risk factors for PEP. Timing of ERCP (weekend vs weekday) was not associated with increased risk of PEP.</p><p><strong>Conclusion: </strong>Weekend ERCPs limited to drainage-only strategies are as safe as weekday procedures in terms of AE rates, effectively managing resources and providing timely biliary decompression for acute cholangitis emergencies, although they often require subsequent definitive interventions.</p><p><strong>Trial registration: </strong>The International Clinical Trials Registry Platform (identifier KCT0005950; https://cris.nih.go.kr).</p>\",\"PeriodicalId\":48770,\"journal\":{\"name\":\"Therapeutic Advances in Gastroenterology\",\"volume\":\"18 \",\"pages\":\"17562848251361694\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357021/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Gastroenterology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17562848251361694\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562848251361694","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Drainage-only strategy on weekend for endoscopic retrograde cholangiopancreatography on the risk of procedure-related adverse events: a prospective observational study.
Background: The feasibility of performing complete endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis during weekends or holidays remains controversial due to concerns over increased risks of adverse events (AEs) in off-hour procedures.
Objectives: To evaluate whether weekend drainage-only ERCP affects the incidence of AEs compared to standard weekday ERCP, and to identify risk factors for post-ERCP pancreatitis (PEP).
Design: Prospective observational study.
Methods: Patients with acute cholangitis, diagnosed based on the Tokyo Guidelines 2018 and naïve major papillae, were prospectively enrolled between 2018 and 2023. Patients were categorized into two groups: the "Weekend ERCP" group, in which initial biliary drainage was performed on weekends with subsequent therapeutic ERCP on weekdays, and the "Weekday ERCP" group, in which all procedures were completed during weekdays. The primary outcome was the incidence of PEP; secondary outcomes included overall AEs and risk factor analysis.
Results: A total of 1772 patients were included (Weekend group: n = 148; Weekday group: n = 1624) in this study. The incidence of PEP was 4.1% in the Weekend group and 4.9% in the Weekday group (p = 0.810). Overall AEs occurred in 3.4% and 4.9% of patients, respectively (p = 0.540). Multivariable analysis identified age ⩽60 years, female sex, history of acute pancreatitis, difficult cannulation, and endoscopic papillary balloon dilation as independent risk factors for PEP. Timing of ERCP (weekend vs weekday) was not associated with increased risk of PEP.
Conclusion: Weekend ERCPs limited to drainage-only strategies are as safe as weekday procedures in terms of AE rates, effectively managing resources and providing timely biliary decompression for acute cholangitis emergencies, although they often require subsequent definitive interventions.
Trial registration: The International Clinical Trials Registry Platform (identifier KCT0005950; https://cris.nih.go.kr).
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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