There is a paucity of literature assessing the impact of endoscopic retrograde cholangiopancreatography (ERCP
) availability at hospitals and the management of acute biliary pancreatitis (ABP). Thus, we sought to evaluate the impact of ERCP
availability on the clinical outcomes of ABP.
The Nationwide Inpatient Sample (2004–2013) was reviewed to identify adult inpatients (≥18 years) with ABP. Clinical outcomes (mortality, severe acute pancreatitis
, and health care resource utilization) between hospitals that perform ERCP
versus hospitals that do not perform ERCP
were compared using multivariate and propensity score–matched analyses.
A majority of the non-ERCP
hospitals were rural (73%) in location. Multivariate analysis demonstrated that the lack of ERCP
availability was independently associated with increased mortality from ABP (odds ratio, 1.83; 95% confidence interval, 1.16–2.88). A propensity score–matched cohort analysis confirmed a significant increase in mortality from ABP in non-ERCP
hospitals (1.1% vs 0.53%; odds ratio, 2.08; 95% confidence interval, 1.05–4.15, P
= 0.037) compared with ERCP
This national survey reveals increased mortality for patients with ABP admitted to hospitals lacking ERCP
services. While there is a need to increase ERCP
availability in rural areas, optimizing strategies for early transfer of patients with ABP to hospitals with ERCP
availability can potentially offset these limitations.