{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:10:24Z","timestamp":1790079024679,"version":"4.0.1"},"reference-count":15,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Hospital length of stay (LOS) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) may reflect baseline condition and underlying disease as well as procedure-related morbidity. We evaluated factors associated with prolonged hospital stay (PLOS) and the association of post-ERCP pancreatitis (PEP) with hospitalization duration. Methods: This retrospective single-center secondary analysis included 806 consecutive patients undergoing ERCP within 48 h of admission in 2019\u20132021. PLOS was defined as total LOS \u2265 12 days, corresponding to hospitalization above the 75th percentile. Modified Poisson regression estimated adjusted risk ratios (aRRs); LOS was also analyzed using negative binomial and median quantile regression. Sensitivity analyses used LOS &gt; 7 and &gt;14 days, a PLOS\/death composite, and a PEP-excluded cohort. Results: Among 788 live discharges with complete LOS data, 176 (22.3%) met the PLOS criterion. In the primary Model A, emergency admission (aRR 3.01, 95% CI 2.01\u20134.51), cholangitis\/postoperative indication (aRR 2.71, 95% CI 1.57\u20134.66), liver disease (aRR 1.85, 95% CI 1.10\u20133.12), and age (aRR 1.12 per 10 years, 95% CI 1.02\u20131.22) were associated with PLOS. PEP was associated with PLOS when added as a post-procedural exposure (aRR 2.34, 95% CI 1.67\u20133.29). Baseline associations were broadly preserved across sensitivity analyses. Conclusions: Prolonged hospitalization was associated mainly with acute clinical context, underlying disease, and patient characteristics. PEP was also associated with longer hospitalization, but this result should be interpreted cautiously because the historical PEP adjudication rule was not retained.<\/jats:p>","DOI":"10.3390\/jcm15187318","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:09:35Z","timestamp":1790075375000},"page":"7318","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Factors Associated with Prolonged Hospitalization in Patients Undergoing ERCP: A Tertiary-Care Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-9841","authenticated-orcid":false,"given":"\u0141ukasz","family":"Nawacki","sequence":"first","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, Aleja IX Wiek\u00f3w Kielc 19, 25-369 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-8211","authenticated-orcid":false,"given":"Agnieszka","family":"Bociek","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, Aleja IX Wiek\u00f3w Kielc 19, 25-369 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Ada","family":"Bielejewska","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Center of Postgraduate Medical Education, Orlowski Hospital, 00-416 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7619-8426","authenticated-orcid":false,"given":"Iwona","family":"Gorczyca-G\u0142owacka","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, Aleja IX Wiek\u00f3w Kielc 19, 25-369 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7752-0459","authenticated-orcid":false,"given":"Stanis\u0142aw","family":"G\u0142uszek","sequence":"additional","affiliation":[{"name":"Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Jastrz\u0119biec, Poland"},{"name":"Department of Surgical Oncology, Holy Cross Cancer Centre in Kielce, 25-734 Kielce, Poland"},{"name":"Department of Surgery, Hospital of the Ministry of Interior and Administration in Kielce, 25-375 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.gtc.2024.08.011","article-title":"Biliary Endoscopic Retrograde Cholangiopancreatography","volume":"53","author":"AbiMansour","year":"2024","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.gtc.2024.07.002","article-title":"Endoscopic Retrograde Cholangiopancreatography: Pancreatic Endoscopy","volume":"53","author":"Han","year":"2024","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1111\/den.15060","article-title":"World Endoscopy Organization Guidelines on Endoscopic Retrograde Cholangiopancreatography Biliary Cannulation and Sphincterotomy Techniques","volume":"37","author":"Aabakken","year":"2025","journal-title":"Dig. Endosc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1053\/j.gastro.2024.10.033","article-title":"Adverse Events Associated with Endoscopic Retrograde Cholangiopancreatography: Systematic Review and Meta-Analysis","volume":"168","author":"Bishay","year":"2025","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1053\/j.gastro.2025.03.009","article-title":"Complications of Endoscopic Retrograde Cholangiopancreatography","volume":"169","author":"Barakat","year":"2025","journal-title":"Gastroenterology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.gie.2025.01.035","article-title":"Thirty-Day Hospital Admission Following High-Risk Outpatient ERCP: Incidence and Analysis of Risk Factors Based on a Secondary Analysis of the Stent Versus Indomethacin Trial Dataset","volume":"102","author":"Yachimski","year":"2025","journal-title":"Gastrointest. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1016\/j.cgh.2022.08.034","article-title":"A Prospective Cohort Study Evaluating PAN-PROMISE, a Patient-Reported Outcome Measure to Detect Post-ERCP Morbidity","volume":"21","author":"Thiruvengadam","year":"2023","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/MCG.0000000000001709","article-title":"US Nationwide Insight into All-Cause 30-Day Readmissions Following Inpatient Endoscopic Retrograde Cholangiopancreatography","volume":"57","author":"Radadiya","year":"2023","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4756","DOI":"10.1007\/s10620-026-10026-4","article-title":"High-Risk Comorbidities Drive Adverse Inpatient Outcomes After ERCP: A National Analysis and Predictive Model","volume":"71","author":"Leslie","year":"2026","journal-title":"Dig. Dis. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Goubert, K., Degroote, H., De Vos, M., Khalenkow, M., and Hindryckx, P. (2024). Factors Associated with the Severity of ERCP-Related Complications: A Retrospective Single-Centre Study. J. Clin. Med., 13.","DOI":"10.21203\/rs.3.rs-4695526\/v1"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Nawacki, \u0141., Bociek, A., Bielejewska, A., Gorczyca-G\u0142owacka, I., and G\u0142uszek, S. (2025). More Than Just a Complication: Post-ERCP Pancreatitis and Its Clinical Determinants in over 800 Procedures. J. Clin. Med., 14.","DOI":"10.3390\/jcm14196916"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Acute Pancreatitis Classification Working Group. Classification of Acute Pancreatitis\u20142012: Revision of the Atlanta Classification and Definitions by International Consensus","volume":"62","author":"Banks","year":"2013","journal-title":"Gut"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1080\/00365521.2023.2282375","article-title":"ERCP for the Initial Management of Malignant Biliary Obstruction\u2014Real-World Data on 596 Procedures","volume":"59","author":"Mikalsen","year":"2024","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1002\/ueg2.12732","article-title":"Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Novel Mechanisms and Prevention by Drugs","volume":"13","author":"Akshintala","year":"2025","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/den.15004","article-title":"Clinical Practice Guidelines for Post-ERCP Pancreatitis 2023","volume":"37","author":"Mukai","year":"2025","journal-title":"Dig. Endosc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7318\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:34:52Z","timestamp":1790076892000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7318"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":15,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187318"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187318","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}