Combination of discharge algorithm and trypsinogen-2 urine dipstick to safely discharge patients after endoscopic retrograde cholangiopancreatography (ERCP)

The most commonly occurring complication of an endoscopic retrograde cholangiopancreaticography (ERCP) is that of the post-ERCP pancreatitis (PEP), with an incidence of 3.5%-9.7%. Approximately 90% of the cases have a mild to moderately severity, although there is still a chance of 1-3% mortality in this group of patients. There is little consensus on which patients are merited by a longer observation period post-procedural, which results in a large variance between hospitals of those who are admitted post-ERCP. Most patients can be discharged under guidance after 2 hours of recovery, but it is essential to identify the patients at high risk for complications such as PEP.
Research question: What is the added value of an urinary trypsinogen-2 dipstick to an already established ERCP discharge tool by Jeurnink et al.?
Objective: To evaluate the ERCP discharge tool in combination with a urinary trypsinogen-2 dipstick test in the early identification of patients at risk for developing a post-ERCP pancreatitis.

ERCP discharge algorithm combined with UT-2 dipstick test (with a cutoff value of 50µg/ml) can accurately distinguish between groups warranting early discharge and those warranting observation post-ERCP.

Primary: 2 hours after ERCP
Secondary: Day 0- 5 days after ERCP or until discharge

Urine dipstick 2 hours after scope-mouth contact of ERCP + patient reported experience measurement at day of discharge