Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Division of Gastroenterology and Gastrointestinal Endoscopy, Vita Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Dig Liver Dis. 2019 Jul;51(7):978-984. doi: 10.1016/j.dld.2018.12.021. Epub 2019 Jan 17.
Prospective studies about endoscopic retrograde cholangio-pancreatography (ERCP) in a community setting are rare.
To assess success and complication rates of routinely-performed ERCP in a regional setting, and the priority quality indicators for ERCP practice.
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.
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.
The procedural questionnaire proved to be an important tool to assess and verify the quality of routinely-performed ERCP performance in a community setting.
在社区环境中进行内镜逆行胰胆管造影术（ERCP）的前瞻性研究很少。
评估在区域环境中常规进行 ERCP 的成功率和并发症发生率，以及 ERCP 实践的优先质量指标。
对在 6 个月期间接受 ERCP 的连续患者进行了前瞻性的全区域观察研究。建立了集中式在线 ERCP 问卷，并用于数据存储。考虑了美国胃肠内镜学会（ASGE）提供的主要质量指标。
18 个中心的 38 名内镜医生共进行了 2388 例 ERCP。ERCP 的最常见适应证是胆总管结石（54.8%），其次是恶性黄疸（22.6%）。在 2293 例（96%）中获得了所需胆管的插管，2176 例（91.1%）的 ERCP 成功。成功率和 ERCP 难度与操作者的经验显著相关（p=0.001 和 p<0.001）。ERCP 难度也与医院的容量显著相关（p<0.01）。总体并发症发生率为 8.4%：术后胰腺炎（PEP）发生在 4.1%的操作中，出血发生在 2.9%，感染发生在 0.8%，穿孔发生在 0.4%。死亡率为 0.4%。所有 ASGE 优先质量指标均得到证实。
该程序问卷被证明是评估和验证社区环境中常规进行的 ERCP 性能质量的重要工具。
