Indiana University School of Medicine, Indianapolis, IN, USA.
Gastrointest Endosc. 2011 Jul;74(1):65-73.e12. doi: 10.1016/j.gie.2011.01.072. Epub 2011 Apr 14.
ERCP practice patterns in the United States are largely unknown.
To characterize the ERCP practice of U.S. gastroenterologists, stratified by their annual case volume: high volume (HV, >200), moderate volume (MV, 50-200), and low volume (LV, <50).
Anonymous electronic survey.
American Society for Gastrointestinal Endoscopy members who are practicing U.S. gastroenterologists.
Among all responders (N = 1006), 63% were derived from community practices. Physicians who performed ERCPs and provided data on annual volume (n = 669) were classified as LV (n = 254), MV (n = 284), and HV (n = 131). During training, 77% of LV physicians did not complete 180 ERCPs compared with 58% of MV and 34% of HV physicians (P < .0001). Only 58% of LV physicians enjoy performing ERCP compared with 88% of MV and 98% of HV physicians (P < .0001); 60% reported being "very comfortable" with ERCP compared with more than 90% of MV and HV physicians (P < .0001). LV physicians are less comfortable with pancreatic duct stenting (PDS) (57% vs 92% [MV] and 98% [HV], P ≤ .02) and using prophylactic PDS. Although HV physicians (42%) were least likely to use short-wire devices (P < .02), use of wire-guided cannulation was similar (74% LV, 72% MV, 66% HV, P = .13). Thirty-seven percent of LV physicians reported comfort with needle-knife sphincterotomy compared with 75% (MV) and 99% (HV) (P < .0001).
Survey completion rate of 18.5%.
Self-reported comfort and/or enjoyment with ERCP is lower among LV physicians. Wire-guided cannulation is used by the majority of all ERCP practitioners, but prophylactic PDS is less frequently used by LV physicians. Because many LV physicians perform ERCP for higher-grade indications and use advanced techniques (eg, needle-knife sphincterotomy), further LV physician ERCP outcomes data are needed.
美国的 ERCP 实践模式在很大程度上是未知的。
按每年的病例量对美国胃肠病学家的 ERCP 实践进行分类，分为高容量（HV，>200）、中容量（MV，50-200）和低容量（LV，<50）。
匿名电子调查。
美国胃肠内镜学会成员，在美国执业的胃肠病学家。
在所有应答者中（N=1006），63%来自社区实践。进行 ERCP 并提供年度容量数据的医生（n=669）被分为 LV（n=254）、MV（n=284）和 HV（n=131）。在培训期间，77%的 LV 医生没有完成 180 例 ERCP，而 MV 和 HV 医生分别为 58%和 34%（P<.0001）。只有 58%的 LV 医生喜欢进行 ERCP，而 MV 和 HV 医生则分别为 88%和 98%（P<.0001）；60%的医生报告说对 ERCP“非常舒适”，而 MV 和 HV 医生则超过 90%（P<.0001）。LV 医生对胰管支架置入术（PDS）（57%对 92%[MV]和 98%[HV]，P≤.02）和预防性 PDS 的应用不太满意。尽管 HV 医生（42%）最不可能使用短导丝设备（P<.02），但导丝引导的插管方法相似（74%的 LV、72%的 MV 和 66%的 HV，P=1.13）。37%的 LV 医生报告说对针刀括约肌切开术感到舒适，而 75%（MV）和 99%（HV）的医生（P<.0001）则感到舒适。
调查完成率为 18.5%。
LV 医生报告的 ERCP 舒适度和/或享受度较低。大多数 ERCP 医生都使用导丝引导的插管，但 LV 医生较少使用预防性 PDS。由于许多 LV 医生对更高等级的指征进行 ERCP 并使用先进技术（如针刀括约肌切开术），因此需要进一步的 LV 医生 ERCP 结果数据。
