Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC 29425, USA.
Am J Gastroenterol. 2013 Aug;108(8):1224-30. doi: 10.1038/ajg.2012.388.
We aimed to establish benchmarks for fluoroscopy time (FT) in endoscopic retrograde cholangiopancreatography (ERCP) and assess the effect of physician practice networking on time trends.
Data from the ERCP Quality Network were used to assess practice variability in FT and establish case- and provider-level benchmarks of the first 200 cases for providers entering more than 100 cases. Trends in FT and high FT, by 50-patient groupings, were assessed by multilevel multivariate linear and logistic regression models.
Median FT was 2.9 minutes, averaging 16% of procedure time. Ninetieth percentiles for the 57 eligible providers were 10 minutes and 22% (n = 9, 185 ERCP). Every 50 cases entered was associated with lower FT. In multivariate analysis, more cases entered, higher lifetime and annual volumes, lower difficulty grade, and manometry had lower FTs; academics, trainee involvement, various therapeutics, and failed cannulation had higher FTs.
FT is highly variable, and many provider and case factors predict FT. FT benchmarks are now available. Self-review of one's case FT might decrease FT.
我们旨在建立内镜逆行胰胆管造影术（ERCP）中透视时间（FT）的基准，并评估医师实践网络对时间趋势的影响。
使用 ERCP 质量网络的数据评估 FT 的实践变异性，并为每位进行超过 100 例手术的医生的前 200 例病例建立病例和提供者水平的基准。通过多水平多元线性和逻辑回归模型评估 FT 和高 FT 的趋势，每 50 例分组。
中位数 FT 为 2.9 分钟，平均占手术时间的 16%。57 名合格提供者的第 90 个百分位数为 10 分钟和 22%（n=9，185 例 ERCP）。每增加 50 例，FT 就会降低。在多变量分析中，更多的病例、更高的终身和年度工作量、更低的难度等级和测压术，FT 越低；学术背景、实习生参与、各种治疗方法和失败的插管，FT 越高。
FT 变化很大，许多提供者和病例因素预测了 FT。现在有了 FT 的基准。自我审查病例的 FT 可能会降低 FT。
