TY - JOUR
T1 - Prospective evaluation of ERCP performance in an Italian regional database study
AU - Mariani, Alberto
AU - Segato, Simone
AU - Anderloni, Andrea
AU - Cengia, Gianpaolo
AU - Parravicini, Marco
AU - Staiano, Teresa
AU - Tontini, Gian Eugenio
AU - Lochis, Davide
AU - Cantù, Paolo
AU - Manfredi, Guido
AU - Amato, Arnaldo
AU - Bargiggia, Stefano
AU - Bernasconi, Giordano
AU - Lella, Fausto
AU - Berni Canani, Marcella
AU - Beretta, Paolo
AU - Ferraris, Luca
AU - Signorelli, Sergio
AU - Pantaleo, Giuseppe
AU - Manes, Gianpiero
AU - Testoni, Pier Alberto
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - Complications
KW - ERCP
KW - Post-ERCP pancreatitis
KW - Quality indicators
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U2 - 10.1016/j.dld.2018.12.021
DO - 10.1016/j.dld.2018.12.021
M3 - Article
AN - SCOPUS:85060870977
VL - 51
SP - 978
EP - 984
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 7
ER -