Prospective evaluation of ERCP performance in an Italian regional database study

Alberto Mariani, Simone Segato, Andrea Anderloni, Gianpaolo Cengia, Marco Parravicini, Teresa Staiano, Gian Eugenio Tontini, Davide Lochis, Paolo Cantù, Guido Manfredi, Arnaldo Amato, Stefano Bargiggia, Giordano Bernasconi, Fausto Lella, Marcella Berni Canani, Paolo Beretta, Luca Ferraris, Sergio Signorelli, Giuseppe Pantaleo, Gianpiero ManesPier Alberto Testoni

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)978-984
JournalDigestive and Liver Disease
Volume51
Issue number7
DOIs
Publication statusPublished - Jan 1 2019

Keywords

  • Complications
  • ERCP
  • Post-ERCP pancreatitis
  • Quality indicators

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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