Abstract
Background
Prospective studies about endoscopic retrograde cholangio-pancreatography (ERCP) in
a community setting are rare.
Aim
To assess success and complication rates of routinely-performed ERCP in a regional
setting, and the priority quality indicators for ERCP practice.
Methods
Prospective region wide observational study on consecutive patients undergoing ERCP
during a 6-month period. A centralized online ERCP questionnaire was built and used
for data storage. Primary quality indicators provided by the American Society of Gastrointestinal
Endoscopy (ASGE) were considered.
Results
38 endoscopists from 18 centers performed a total of 2388 ERCP. The most common indication
for ERCP was choledocholitiasis (54.8%) followed by malignant jaundice (22.6%). Cannulation
of the desired duct was obtained in 2293 cases (96%) and ERCP was successful in 2176
cases (91.1%). Success and ERCP difficulty were significantly related to the experience
of the operator (p = 0.001 and p < 0.001, respectively). ERCP difficulty was also
significantly related to volume centers (p < 0.01). The overall complication rate
was 8.4%: post-ERCP pancreatitis (PEP) occurred in 4.1% of procedures, bleeding in
2.9%, infection in 0.8%, perforation in 0.4%. Mortality rate was 0.4%. All the ASGE
priority quality indicators for ERCP were confirmed.
Conclusions
The procedural questionnaire proved to be an important tool to assess and verify the
quality of routinely-performed ERCP performance in a community setting.
Keywords
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Article info
Publication history
Published online: January 17, 2019
Accepted:
December 25,
2018
Received:
September 29,
2018
Identification
Copyright
© 2019 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
