Prospective evaluation of ERCP performance in an Italian regional database study

被引：22

作者：

Mariani, Alberto ^{[1
]}

Segato, Simone ^{[2
]}

Anderloni, Andrea ^{[3
]}

Cengia, Gianpaolo ^{[4
]}

Parravicini, Marco ^{[5
]}

Staiano, Teresa ^{[6
]}

Tontini, Gian Eugenio ^{[7
]}

Lochis, Davide ^{[8
]}

Cantu, Paolo ^{[9
]}

Manfredi, Guido ^{[10
]}

Amato, Arnaldo ^{[11
]}

Bargiggia, Stefano ^{[12
]}

Bernasconi, Giordano ^{[13
]}

Lella, Fausto ^{[14
]}

Canani, Marcella Berni ^{[15
,16
]}

Beretta, Paolo ^{[17
]}

Ferraris, Luca ^{[18
]}

Signorelli, Sergio ^{[19
]}

Pantaleo, Giuseppe ^{[20
]}

Manes, Gianpiero ^{[21
]}

Testoni, Pier Alberto ^{[2
]}

机构：

[1] Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Pancreas Translat & Clin Res Ctr, Pancreato Biliary Endoscopy & Endosonog Div, Via Olgettina 60, I-20132 Milan, Italy

[2] Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Div Gastroenterol & Gastrointestinal Endoscopy, Milan, Italy

[3] Humanitas Res Hosp, Div Gastroenterol, Digest Endoscopy Unit, Milan, Italy

[4] Osped Manerbio, Endoscopy Unit, Brescia, Italy

[5] Azienda Osped Univ, Osped Circolo Varese, Gastroenterol & Digest Endoscopy Unit, Varese, Italy

[6] Ist Ospitalieri Cremona, Digest Endoscopy & Gastroenterol Unit, Cremona, Italy

[7] IRCCS Policlin San Donato, Gastroenterol & Digest Endoscopy Unit, San Donato Milanese, Italy

[8] Policlin Monza, Endoscopy Unit, Monza, Italy

[9] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Gastroenterol & Endoscopy Unit, Milan, Italy

[10] ASST Crema, Maggiore Hosp, Gastroenterol & Digest Endoscopy Dept, Crema, Italy

[11] Valduce Hosp, Dept Gastroenterol Unit, Como, Italy

[12] A Manzoni Hosp, Div Gastroenterol, Lecce, Italy

[13] Busto Arsizio Hosp, Gastroenterol & Digest Endoscopy Unit, Busto Arsizio, Varese, Italy

[14] Policlin San Pietro, Gastroenterol & Digest Endoscopy Unit, Bergamo, Italy

[15] ASST Vimercate, Digest Endoscopy & Gastroenterol Unit, Monza, Italy

[16] ASST Vimercate, Digest Endoscopy & Gastroenterol Unit, Brianza, Italy

[17] ICCS, Gastroenterol & Digest Endoscopy Unit, Milan, Italy

[18] Gastroenterol & Endoscopia Digestiva ASST, Valleolona PO, Gallarate, Varese, Italy

[19] ASST Papa Giovanni XXIII, Gastroenterol & Gastrointestinal Endoscopy Unit, Bergamo, Italy

[20] Univ Vita Salute San Raffaele, Fac Psychol, UniSR Social Lab Res Methods, Milan, Italy

[21] ASST Rhodense Garbagnate Milanese, Dept Gastroenterol & Digest Endoscopy, Milan, Italy

来源：

DIGESTIVE AND LIVER DISEASE | 2019年 / 51卷 / 07期

关键词：

ERCP; Complications; Post-ERCP pancreatitis; Quality indicators; ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY; RISK-FACTORS; PROPOFOL INFUSION; THERAPEUTIC ERCP; ROUTINE ERCP; COMPLICATIONS; PANCREATITIS; BILIARY; VOLUME; SPHINCTEROTOMY;

D O I：

10.1016/j.dld.2018.12.021

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Prospective studies about endoscopic retrograde cholangio-pancreatography (ERCP) in a community setting are rare. Aim: To assess success and complication rates of routinely-performed ERCP in a regional setting, and the priority quality indicators for ERCP practice. Methods: 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. Results: 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. Conclusions: The procedural questionnaire proved to be an important tool to assess and verify the quality of routinely-performed ERCP performance in a community setting. (C) 2019 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.

引用

页码：978 / 984

页数：7

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