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Dig Liver Dis ; 51(7): 978-984, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30718203

RESUMO

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.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Colangiopancreatografia Retrógrada Endoscópica/estatística & dados numéricos , Hemorragia/epidemiologia , Pancreatite/epidemiologia , Indicadores de Qualidade em Assistência à Saúde , Cateterismo/estatística & dados numéricos , Coledocolitíase/diagnóstico por imagem , Coledocolitíase/cirurgia , Bases de Dados Factuais , Hemorragia/etiologia , Humanos , Itália/epidemiologia , Icterícia/diagnóstico por imagem , Modelos Logísticos , Pancreatite/etiologia , Estudos Prospectivos , Inquéritos e Questionários
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