Donato Giulio, Occhipinti Pietro, Correale Loredana, Spadaccini Marco, Repici Alessandro, Anderloni Andrea, Fugazza Alessandro, Mosca Piergiorgio, Tringali Andrea, Costamagna Guido, Bulajic Milutin, de Pretis Giovanni, Gabbrielli Armando, Di Matteo Francesco Maria, Faggiani Roberto, Ayoubi Mohammad, De Luca Luca, Cantù Paolo, Blois Matteo, Dell'Amico Iginio, Maurano Attilio, Savarese Maria Flavia, Manes Giampiero, Ferraro Raffaella, Barberis Mauro, Hassan Cesare
Gastroenterology Unit, Department of Oncological and Specialty Medicine, Ospedale "Maggiore della Carità", Novara, Italy.
Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy.
Endosc Int Open. 2021 Sep 16;9(10):E1563-E1571. doi: 10.1055/a-1531-4691. eCollection 2021 Oct.
Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure with a relatively high rate of adverse events. Data on training of operators and fulfillment of quality indicators in Italy are scarce. The goal of this study was to assess the overall quality of ERCP in Italy compared to international standards. This was a prospective, observational study from different Italian centers performing ERCP. Operators answered a questionnaire, then recorded data on ERCPs over a 1-to 3-month period. Nineteen Italian centers participated in the study. The most common concern of operators about training was the lack of structured programs. Seven/19 centers routinely used conscious sedation for ERCP. Forty-one experienced operators and 21 trainees performed 766 ERCPs: a successful deep biliary cannulation in native-papilla patients was achieved in 95.1 % of cases; the post-ERCP pancreatitis (PEP) rate was 5.4 % in native-papilla patients; cholangitis rate was 1.0 %; bleeding and perforation occurred in 2.7 % and 0.4 % of the patients, respectively. This study revealed that, overall, ERCP is performed in the participating Italian centers meeting good quality standards, but structured training and sedation practice are still subpar. The bleeding and perforation rate slightly exceeded the American Society of Gastrointestinal Endoscopy indicator targets but they are comparable to the reported rates from other international surveys.
内镜逆行胰胆管造影术（ERCP）是一项复杂的操作，不良事件发生率相对较高。意大利关于操作人员培训和质量指标达成情况的数据匮乏。本研究的目的是评估意大利ERCP的整体质量，并与国际标准进行比较。这是一项来自意大利不同进行ERCP操作中心的前瞻性观察性研究。操作人员回答了一份问卷，然后记录了1至3个月期间ERCP操作的数据。19个意大利中心参与了该研究。操作人员对培训最普遍的担忧是缺乏结构化课程。19个中心中有7个常规使用清醒镇静进行ERCP操作。41名经验丰富的操作人员和21名实习生共进行了766例ERCP操作：在乳头正常的患者中，95.1%的病例成功实现了深部胆管插管；乳头正常的患者中，ERCP术后胰腺炎（PEP）发生率为5.4%；胆管炎发生率为1.0%；出血和穿孔分别发生在2.7%和0.4%的患者中。这项研究表明，总体而言，参与研究的意大利中心进行的ERCP操作符合良好的质量标准，但结构化培训和镇静实践仍未达标准。出血和穿孔率略高于美国胃肠内镜学会的指标目标，但与其他国际调查报道的发生率相当。
