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When to Discharge a Patient After Endoscopy: A Narrative Review

  • Received : 2021.03.22
  • Accepted : 2021.06.08
  • Published : 2022.01.30

Abstract

Video endoscopy is an important modality for the diagnosis and treatment of various gastrointestinal diseases. Most endoscopic procedures are performed as outpatient basis, sometimes requiring sedation and deeper levels of anesthesia. Moreover, advances in endoscopic techniques have allowed invasion into the third space and the performance of technically difficult procedures that require the utmost precision. Hence, formulating strategies for the discharge of patients requiring endoscopy is clinically and legally challenging. In this review, we have discussed the various criteria and scores for the discharge of patients who have undergone endoscopic procedures with and without anesthesia.

Keywords

References

  1. Cohen LB, Delegge MH, Aisenberg J, et al. AGA Institute review of endoscopic sedation. Gastroenterology 2007;133:675-701.  https://doi.org/10.1053/j.gastro.2007.06.002
  2. Dumonceau J-M, Riphaus A, Schreiber F, et al. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and associates guideline-updated June 2015. Endoscopy 2015;47:1175-1189.  https://doi.org/10.1055/s-0034-1393414
  3. Trevisani L, Cifala V, Gilli G, Matarese V, Zelante A, Sartori S. Post-anaesthetic discharge scoring system to assess patient recovery and discharge after colonoscopy. World J Gastrointest Endosc 2013;5:502-507.  https://doi.org/10.4253/wjge.v5.i10.502
  4. Sato M, Horiuchi A, Tamaki M, et al. Safety and effectiveness of nurse-administered propofol sedation in outpatients undergoing gastrointestinal endoscopy. Clin Gastroenterol Hepatol 2019;17:1098-1104.e1.  https://doi.org/10.1016/j.cgh.2018.06.025
  5. Aljebreen AM, Almadi MA, Leung FW. Sedated vs unsedated colonoscopy: a prospective study. World J Gastroenterol 2014;20:5113-5118.  https://doi.org/10.3748/wjg.v20.i17.5113
  6. Practice guidelines for moderate procedural sedation and analgesia 2018: a report by the American Society of Anesthesiologists task force on moderate procedural sedation and analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. Anesthesiology 2018;128:437-479.  https://doi.org/10.1097/ALN.0000000000002043
  7. Lugay M, Otto G, Kong M, Mason DJ, Wilets I. Recovery time and safe discharge of endoscopy patients after conscious sedation. Gastroenterol Nurs 1996;19:194-200.  https://doi.org/10.1097/00001610-199611000-00002
  8. Rockall TA, Logan RF, Devlin HB, Northfield TC. Selection of patients for early discharge or outpatient care after acute upper gastrointestinal haemorrhage. National Audit of Acute Upper Gastrointestinal Haemorrhage. Lancet 1996;347:1138-1140.  https://doi.org/10.1016/S0140-6736(96)90607-8
  9. Rickard A, Squire R, Freshwater DA, Smith JE. Validation of the Glasgow Blatchford score to enable safe discharge of selected patients with upper GI bleeding. J R Nav Med Serv 2012;98:12-14.  https://doi.org/10.1136/jrnms-98-12
  10. Jensen DM, Eklund S, Persson T, et al. Reassessment of rebleeding risk of Forrest IB (oozing) peptic ulcer bleeding in a large international randomized trial. Am J Gastroenterol 2017;112:441-446. https://doi.org/10.1038/ajg.2016.582
  11. Longstreth GF, Feitelberg SP. Outpatient care of selected patients with acute non-variceal upper gastrointestinal haemorrhage. Lancet 1995;345:108-111.  https://doi.org/10.1016/S0140-6736(95)90068-3
  12. de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol 2015;63:743-752.  https://doi.org/10.1016/j.jhep.2015.05.022
  13. Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W, Practice Guidelines Committee of the American Association for the Study of Liver Diseases, Practice Parameters Committee of the American College of Gastroenterology. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology 2007;46:922-938.  https://doi.org/10.1002/hep.21907
  14. Sami SS, Haboubi HN, Ang Y, et al. UK guidelines on oesophageal dilatation in clinical practice. Gut 2018;67:1000-1023.  https://doi.org/10.1136/gutjnl-2017-315414
  15. Singh P, Singh A, Singh A, Sharma G, Bhatia PK, Grover AS. Long term outcome in patients with esophageal stenting for cancer esophagus - our experience at a rural hospital of punjab, India. J Clin Diagn Res 2016;10:PC06-PC09.  https://doi.org/10.7860/JCDR/2016/22950.8994
  16. Martin DF, Laasch H-U. Gastroduodenal stenting. Semin Intervent Radiol 2004;21:167-179.  https://doi.org/10.1055/s-2004-860875
  17. Ho K-S, Quah H-M, Lim J-F, Tang C-L, Eu K-W. Endoscopic stenting and elective surgery versus emergency surgery for left-sided malignant colonic obstruction: a prospective randomized trial. Int J Colorectal Dis 2012;27:355-362.  https://doi.org/10.1007/s00384-011-1331-4
  18. Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 2016;48:489-496.  https://doi.org/10.1055/s-0042-100456
  19. Bechtold ML, Matteson ML, Choudhary A, Puli SR, Jiang PP, Roy PK. Early versus delayed feeding after placement of a percutaneous endoscopic gastrostomy: a meta-analysis. Am J Gastroenterol 2008;103:2919-2924.  https://doi.org/10.1111/j.1572-0241.2008.02108.x
  20. Gumaste VV, Bhamidimarri KR, Bansal R, Sidhu L, Baum J, Walfish A. Factors predicting early discharge and mortality in post-percutaneous endoscopic gastrostomy patients. Ann Gastroenterol 2014;27:42-47. 
  21. Kim Y, Kim YW, Choi IJ, et al. Cost comparison between surgical treatments and endoscopic submucosal dissection in patients with early gastric cancer in Korea. Gut Liver 2015;9:174-180.  https://doi.org/10.5009/gnl13299
  22. Choi JY, Park YS, Na G, et al. Safety and effectiveness of endoscopic mucosal resection or endoscopic submucosal dissection for gastric neoplasia within 2 days' hospital stay. Medicine (Baltimore) 2019;98:e16578. 
  23. Tomiki Y, Kawai M, Takehara K, et al. Clinical pathway to discharge 3 days after colorectal endoscopic submucosal dissection. Dig Endosc 2015;27:679-686.  https://doi.org/10.1111/den.12468
  24. Inoue H, Sato H, Ikeda H, et al. Per-oral endoscopic myotomy: a series of 500 patients. J Am Coll Surg 2015;221:256-264.  https://doi.org/10.1016/j.jamcollsurg.2015.03.057
  25. Cloutier Z, Mann A, Doumouras AG, Hong D. Same-day discharge is safe and feasible following POEM surgery for esophageal motility disorders. Surg Endosc 2021;35:3398-3404.  https://doi.org/10.1007/s00464-020-07781-4
  26. Jeurnink SM, Siersema PD, Steyerberg EW, et al. Predictors of complications after endoscopic retrograde cholangiopancreatography: a prognostic model for early discharge. Surg Endosc 2011;25:2892-2900.  https://doi.org/10.1007/s00464-011-1638-9
  27. Lee YK, Yang MJ, Kim SS, et al. Prediction of post-endoscopic retrograde cholangiopancreatography pancreatitis using 4-hour post-endoscopic retrograde cholangiopancreatography serum amylase and lipase levels. J Korean Med Sci 2017;32:1814-1819.  https://doi.org/10.3346/jkms.2017.32.11.1814
  28. Freeman ML, Nelson DB, Sherman S, et al. Same-day discharge after endoscopic biliary sphincterotomy: observations from a prospective multicenter complication study. The Multicenter Endoscopic Sphincterotomy (MESH) Study Group. Gastrointest Endosc 1999;49:580-586.  https://doi.org/10.1016/S0016-5107(99)70385-8
  29. Varadarajulu S, Bang JY, Sutton BS, Trevino JM, Christein JD, Wilcox CM. Equal efficacy of endoscopic and surgical cystogastrostomy for pancreatic pseudocyst drainage in a randomized trial. Gastroenterology 2013;145:583-590.e1.  https://doi.org/10.1053/j.gastro.2013.05.046
  30. Varadarajulu S, Lopes TL, Wilcox CM, Drelichman ER, Kilgore ML, Christein JD. EUS versus surgical cyst-gastrostomy for management of pancreatic pseudocysts. Gastrointest Endosc 2008;68:649-655.  https://doi.org/10.1016/j.gie.2008.02.057
  31. Melman L, Azar R, Beddow K, et al. Primary and overall success rates for clinical outcomes after laparoscopic, endoscopic, and open pancreatic cystgastrostomy for pancreatic pseudocysts. Surg Endosc 2009;23:267-271.  https://doi.org/10.1007/s00464-008-0196-2
  32. Mok SRS, Ho HC, Gaughan JP, Elfant AB. Therapeutic endoscopy can be performed safely in an ambulatory surgical center: a multicenter, prospective study. Diagn Ther Endosc 2016;2016:7168280.