S176 Safety Outcomes of Same-Day Endoscopic Retrograde Cholangiopancreatography and Colonoscopy: A Retrospective Cohort Study

Introduction: Same-day endoscopic retrograde cholangiopancreatography (ERCP) and colonoscopy are occasionally performed to minimize patient burden and improve procedural efficiency. However, concerns remain regarding cumulative sedation risks and post-procedural complications. This study aimed to evaluate the safety outcomes associated with same-day ERCP and colonoscopy. Methods: We conducted a retrospective cohort study of adult patients who underwent same-day ERCP and colonoscopy at a tertiary care center between 2018 and 2025. Data collected included demographics, procedural indications, type of sedation, technical success, and complications occurring immediately or within 30 days post-procedure. Statistical analysis was performed using JMP software (Version 15.0.0 (2019); SAS Institute Inc., Cary, NC). Results: A total of 153 patients were included (mean age 58.9 ± 16.4 years; range 21–98; 62.7% men). ERCP indications included biliary pathology (n = 109), malignancy (n = 23), and pancreatic disease (n = 11). Colonoscopy indications were colorectal cancer screening (n = 78) and inflammatory bowel disease (n = 25). Technical success was achieved in 152/153 ERCPs and 149/150 colonoscopies. Twenty-two patients (14.4%) were inpatient at the time of the procedures. The average hospital length of stay was 0.69 ± 2.02 days. Within 30 days, 19 patients (12.4%) were readmitted, and 22 (14.4%) experienced complications. The most common complications were abdominal pain (n = 8), post-ERCP pancreatitis (n = 6), and bleeding (n = 3). Less frequent complications included nausea/vomiting (n = 2), spontaneous bacterial peritonitis (n = 1), cholangitis (n = 1), and infection (n = 1). Mean procedure duration was 89.5 ± 38.1 minutes; mean anesthesia time was 120.4 ± 41.3 minutes. No procedure-related mortalities occurred. Conclusion: Same-day ERCP and colonoscopy were found to be technically successful, safe, and well-tolerated in a diverse and medically complicated patient population. These findings support the feasibility of same-day scheduling in appropriately selected patients, potentially enhancing procedural unit efficiency and reducing episodes of anesthesia when compared to performing these procedures separately, without increasing adverse event risk.