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Pelletier, Elise M., M.S.; Lacey, Michael J., M.S.; Sullivan, Erin M., Ph.D.; Johnson, David A., M.D.*

American Journal of Gastroenterology: October 2004 - Volume 99 - Issue 10 - p S231
Abstracts Submitted for the 69th Annual Scientific Meeting of the American College of Gastroenterology: October 29–November 3, 2004, Orlando, Florida: OUTCOMES RESEARCH

Boston Scientific Corporation, Natick, Massachusetts and Eastern Virginia School of Medicine, Norfolk, Virginia.

Purpose: To evaluate the rate of acute pancreatitis following ERCP.

Methods: All patients undergoing an endoscopic retrograde cholangiopan-creatography (ERCP) procedure (CPT 43260–43272) between April 1 and September 30, 2002 were identified from a nationally representative managed care database (IHCIS, Waltham, MA). Patients with a pancreatitis diagnosis (ICD-9 577.x) within 90 days prior to the ERCP procedure were removed from the analysis. Patients were followed for 90 days to determine the rate of acute pancreatitis (principal ICD-9 577.0) after ERCP. Mean overall inpatient hospital costs and medical costs (professional, facility outpatient, ancillary) also were calculated.

Results: The study included 1,587 patients who underwent an ERCP procedure between April and September 2002. The average age was 52 years; 64% of patients were female. Two hundred twenty-one patients (13.9%) received a principal diagnosis of acute pancreatitis within 90 days of the ERCP procedure. The average time between ERCP and initial diagnosis of acute pancreatitis was approximately 6 days (± 14.7 days). Overall mean inpatient hospital costs during the 90-day follow-up were significantly higher among patients who developed acute pancreatitis versus those with no acute pancreatitis ($18,137 vs. $10,006; p <0.001). In addition, significantly higher medical costs were observed among patients who developed acute pancreatitis ($8,297 vs. $7,581; p <0.01).

Conclusions: Among 1,587 patients undergoing ERCP, approximately 14% developed acute pancreatitis within 90 days of follow-up. Inpatient and outpatient facility, professional, and ancillary costs were significantly higher among patients with a diagnosis of acute pancreatitis during the 90-day follow-up period versus those without a diagnosis. The rate of acute pancreatitis among patients undergoing ERCP may be higher than previously reported estimates in the literature. Further exploration of these findings is warranted and the incidence and time horizons for ERCP-related pancreatitis should be reevaluated.

© The American College of Gastroenterology 2004. All Rights Reserved.