Association of greater intravenous volume infusion with shorter hospitalization for patients with post-ERCP pancreatitis

作者：Sagi Sashidhar V; Schmidt Suzette; Fogel Evan; Lehman Glen A; McHenry Lee; Sherman Stuart; Watkins James; Cote Gregory A^*

来源：Journal of Gastroenterology and Hepatology, 2014, 29(6): 1316-1320.

DOI：10.1111/jgh.12511

• endoscopic retrograde cholangiopancreatography
• intravenous infusion
• pancreatitis

Background and AimThere are no data specifically correlating early intravenous volume infusion (IVI) with the length of hospitalization for postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).
MethodsWe conducted a retrospective cohort study of patients admitted within 24h after ERCP to our institute with PEP. IVI during the first 24h after ERCP was assessed. Primary outcome was severity of PEP, defined by length of hospitalization according to consensus guidelines: mild3, moderate 4-10, and severe>10 days.
ResultsOf 72 eligible patients, 41 (56.9%) had mild and 31 (43.1%) moderate/severe PEP. Both groups had comparable demographics, indications, and procedural factors except patients with moderate/severe PEP were older (median age 49 vs 36 years, P=0.05) and more likely to be discharged and readmitted within the first 24h (41.9% vs 14.6%, P<0.01). Patients with mild PEP received significantly greater IVI during the first 24h (2834mL [2046, 3570] vs 2044mL [1227, 2875], P<0.02) and 50% more fluid post-ERCP (2270mL [1435, 2961] vs 1515 [950-2350], P<0.02) compared with those with at least moderate PEP.
ConclusionIn patients with PEP, greater IVI during the first 24h after ERCP is associated with reduced length of hospitalization. Lower IVI was more commonly observed in individuals who were discharged and then readmitted during the first 24h.

• 出版日期2014-6