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内镜逆行胰胆管造影术和内镜超声检查的性能指标:欧洲胃肠内镜学会(ESGE)质量改进倡议。

Performance measures for endoscopic retrograde cholangiopancreatography and endoscopic ultrasound: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative.

作者信息

Domagk Dirk, Oppong Kofi W, Aabakken Lars, Czakó Laszlo, Gyökeres Tibor, Manes Gianpiero, Meier Peter, Poley Jan-Werner, Ponchon Thierry, Tringali Andrea, Bellisario Cristina, Minozzi Silvia, Senore Carlo, Bennett Cathy, Bretthauer Michael, Hassan Cesare, Kaminski Michal F, Dinis-Ribeiro Mario, Rees Colin J, Spada Cristiano, Valori Roland, Bisschops Raf, Rutter Matthew D

机构信息

Department of Medicine I, University of Muenster, Warendorf, Germany.

HPB Unit, Freeman Hospital, Newcastle upon Tyne, UK.

出版信息

United European Gastroenterol J. 2018 Dec;6(10):1448-1460. doi: 10.1177/2050640618808157. Epub 2018 Oct 19.

Abstract

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a short list of key performance measures for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). We recommend that endoscopy services across Europe adopt the following seven key and one minor performance measures for EUS and ERCP, for measurement and evaluation in daily practice at centre and endoscopist level: Adequate antibiotic prophylaxis before ERCP (key performance measure, at least 90%); antibiotic prophylaxis before EUS-guided puncture of cystic lesions (key performance measure, at least 95%); bile duct cannulation rate (key performance measure, at least 90%); tissue sampling during EUS (key performance measure, at least 85%); appropriate stent placement in patients with biliary obstruction below the hilum (key performance measure, at least 95%); bile duct stone extraction (key performance measure, at least 90%); post-ERCP pancreatitis (key performance measure, less than 10%); and adequate documentation of EUS landmarks (minor performance measure, at least 90%). This present list of quality performance measures for ERCP and EUS recommended by the ESGE should not be considered to be exhaustive; it might be extended in future to address further clinical and scientific issues.

摘要

欧洲胃肠内镜学会(ESGE)和欧洲胃肠病学联合会列出了一份关于超声内镜(EUS)和内镜逆行胰胆管造影(ERCP)的关键绩效指标简表。我们建议欧洲各地的内镜服务机构采用以下针对EUS和ERCP的七项关键指标及一项次要指标,用于在中心和内镜医师层面的日常实践中进行测量和评估:ERCP前给予充分的抗生素预防(关键绩效指标,至少90%);EUS引导下穿刺囊性病变前给予抗生素预防(关键绩效指标,至少95%);胆管插管率(关键绩效指标,至少90%);EUS检查期间的组织采样(关键绩效指标,至少85%);对肝门以下胆管梗阻患者进行适当的支架置入(关键绩效指标,至少95%);胆管结石取出(关键绩效指标,至少90%);ERCP术后胰腺炎(关键绩效指标,低于10%);以及EUS标志的充分记录(次要绩效指标,至少90%)。ESGE推荐的这份关于ERCP和EUS的质量绩效指标清单不应被视为详尽无遗;未来可能会进行扩展以解决更多临床和科学问题。

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