S1217 Factors That Impact Patients Who Present With Acute Gallstone Pancreatitis Who Undergo ERCP vs ERCP + Cholecystectomy

Introduction: Studies recommend same-admission cholecystectomy after endoscopic retrograde cholangiopancreatography (ERCP) in patients who present with acute gallstone pancreatitis (AGP). We investigate mortality, length of stay (LOS), hospital costs, hospital characteristics, and sociodemographic of patients in the US who present with gallstone pancreatitis who undergo ERCP only vs ERCP + cholecystectomy. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016-2019. Patients with a diagnosis of AGP aged > 18 years and those who underwent ERCP and cholecystectomy were included in the analysis using International Classification of Diseases - 10th Edition codes. A 2-sample t-test was performed to assess LOS, mortality rate, and hospital costs. A multivariable binary logistic regression analysis was used to examine the effects of socio-demographic variables, with a significance level of P < 0.001. Results: The occurrence of ERCP decreased from 5.61% to 5.14% (P< 0.001). The performance of ERCP + Cholecystectomy decreased from 3.86% to 3.30% (P< 0.001). Mortality for those undergoing only ERCP was higher at 2.31% (P< 0.001). LOS for those undergoing ERCP was higher at 6.51 days (P< 0.001). The hospital costs were lower for those undergoing ERCP at $84,380.68 (P=0.040). Performance of both procedures decreased from 3.86% to 3.30% (P< 0.001). The hospital characteristics were not significantly different. Age 30-50 (OR 0.83) was less likely to undergo both procedures. African Americans (OR 0.84) and Asians (OR 0.90) are less likely to undergo both procedures. Females were more likely to undergo both procedures (OR 1.04). All median income less likely to undergo both procedures (OR 0.93, 0.98, 0.94 respectively). Medicare (OR 0.78) and Medicaid (0.86) were less likely to undergo both procedures however those without insurance were more likely to undergo both procedures (OR 1.12). Conclusion: Patients who only underwent ERCP had higher mortality, hospital costs, and LOS. Minorities, low-income patients, and Medicare/Medicaid patients were less likely to undergo ERCP + cholecystectomy. Our results to show that ERCP and cholecystectomy should be performed during the same admission for patients who present with AGP. Future studies should investigate barriers that prevent this from occurring and why national trends are decreasing.