Pécsi Dániel, Hegyi Péter, Szentesi Andrea, Gódi Szilárd, Pakodi Ferenc, Vincze Áron
Általános Orvostudományi Kar, Transzlációs Medicina Intézet, Pécsi Tudományegyetem Pécs.
MTA-Lendület Kutatócsoport, Klinikai Központ, I. Belgyógyászati Klinika, Szegedi Tudományegyetem Szeged.
Orv Hetil. 2018 Sep;159(37):1506-1515. doi: 10.1556/650.2018.31145.
The continuous monitoring of quality indicators in gastrointestinal endoscopy has become an essential requirement nowadays. Most of these data cannot be extracted from the currently used free text reports, therefore a structured web-based data-collecting system was developed to record the indicators of pancreatobiliary endoscopy.
A structured data-collecting system, the ERCP Registry, was initiated to monitor endoscopic retrograde cholangiopancreatography (ERCP) examinations prospectively, and to verify its usability.
From January 2017, all ERCPs performed at the First Department of Medicine, University of Pécs, have been registered in the database. In the first year, the detailed data of 595 examinations were entered into the registry. After processing these data, the testing period of the registry is now finished.
On 447 patients, 595 ERCPs were performed. The success rate of cannulation is 93.8% if all cases are considered. Difficult biliary access was noted in 32.1% of patients with native papilla, and successful cannulation was achieved in 81.0% of these cases during the first procedure. Post-ERCP pancreatitis was observed in 13 cases (2.2%), clinically significant post-papillotomy bleeding was registered in 2 cases (0.3%), while 27 patients (4.5%) developed temporary hypoxia during the procedure. 30-day follow-up was successful in 75.5% of the cases to detect late complications. All of the quality indicators determined by the American Society of Gastrointestinal Endoscopy (ASGE) were possible to monitor with the help of the registry. Our center already complies with most of these criteria.
Continuous monitoring of the quality indicators of endoscopic interventions are not supported by the current hospital information system but it became possible with our registry. The ERCP Registry is a suitable tool to detect the quality of patient care and also useful for clinical research. Several endoscopy units have joined already this initiative and it is open for further centres through our web page ( https://tm-centre.org/hu/regiszterek/ercp-regiszter/ ). Orv Hetil. 2018; 159(37): 1506-1515.
如今，持续监测胃肠内镜检查的质量指标已成为一项基本要求。目前使用的自由文本报告无法提取这些数据中的大部分，因此开发了一个基于网络的结构化数据收集系统来记录胰胆内镜检查的指标。
启动一个结构化数据收集系统，即内镜逆行胰胆管造影（ERCP）登记系统，以对内镜逆行胰胆管造影检查进行前瞻性监测，并验证其可用性。
自2017年1月起，佩奇大学医学院第一内科进行的所有ERCP检查均已登记在数据库中。第一年，595例检查的详细数据被录入登记系统。在处理这些数据后，登记系统的测试阶段现已结束。
对447例患者进行了595次ERCP检查。如果考虑所有病例，插管成功率为93.8%。在32.1%的有天然乳头的患者中发现胆管插管困难，其中81.0%的病例在首次手术时成功插管。观察到13例（2.2%）发生ERCP后胰腺炎，2例（0.3%）记录到具有临床意义的乳头切开术后出血，而27例患者（4.5%）在手术过程中出现暂时性低氧血症。75.5%的病例成功进行了30天随访以检测晚期并发症。借助该登记系统，可以监测美国胃肠内镜学会（ASGE）确定的所有质量指标。我们中心已经符合这些标准中的大部分。
目前的医院信息系统不支持对内镜干预质量指标的持续监测，但通过我们的登记系统已成为可能。ERCP登记系统是检测患者护理质量的合适工具，也有助于临床研究。已有几个内镜科室加入了这一倡议，并且通过我们的网页（https://tm-centre.org/hu/regiszterek/ercp-regiszter/）向更多中心开放。《匈牙利医学周报》。2018年；159（37）：1506 - 1515。
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