Prospective evaluation of post-ERCP gastrointestinal dysfunction using the I-FEED scoring system: A cohort study.

To determine the incidence of gastrointestinal dysfunction after ERCP, identify factors associated with its development, and evaluate the correlation between the I-FEED score and clinical outcomes, this single-center, prospective, observational cohort study consecutively enrolled patients undergoing elective ERCP, with 30-day follow-up. Inclusion criteria were: age ≥ 18 years and scheduled elective ERCP for any indication. Collected data included demographics, procedural details, I-FEED scores, length of stay, Quality of Recovery-9 scores, and 30-day readmission. The I-FEED score was the primary assessment tool. An I-FEED score ≥ 6 is defined as Post-ERCP gastrointestinal dysfunction (POGD). Analyses were performed using SPSS v25.0. Among 273 analyzed patients (59.34% male), choledocholithiasis was the most common indication (63.73%). POGD occurred in 54 patients (19.8%). Post-ERCP pancreatitis (PEP) was the most common condition associated with POGD (34 cases, 62.9%). Univariate analysis identified several factors associated with POGD, including younger age, suspected sphincter of Oddi dysfunction (SOD), PEP, cholangitis, bleeding, difficult cannulation, >1 pancreatic guidewire passage, pancreatic contrast injection, and pancreatic sphincterotomy. In multivariate analysis, younger age, suspected SOD, difficult cannulation, pancreatic sphincterotomy, and PEP were independently associated with POGD. An I-FEED score ≥ 6 was statistically significantly associated with: a longer median length of stay compared to scores < 6, a higher rate of nasogastric tube insertion, and lower patient satisfaction scores. POGD is a frequent and clinically significant occurrence after ERCP, affecting nearly one-fifth of patients. The I-FEED scoring system appears valuable for objectively assessing gastrointestinal recovery post-ERCP and may inform clinical management and postoperative care.