ERCP PERFORMANCE IN A TERTIARY BRAZILIAN CENTER: FOCUS ON NEW RISK FACTORS, COMPLICATIONS AND QUALITY INDICATORS

Area of Science:

• Gastroenterology
• Medical Procedures
• Patient Safety

Background:

• Endoscopic Retrograde Cholangiopancreatography (ERCP) is a vital procedure but carries risks of complications.
• Identifying and mitigating these risks is crucial for improving patient outcomes.
• Previous studies have explored various risk factors, but a comprehensive analysis is needed.

Purpose of the Study:

• To identify significant risk factors associated with early and late complications following ERCP.
• To evaluate the quality of ERCP procedures by analyzing procedural elements and outcomes.
• To propose new quality indicators for ERCP based on identified risk factors.

Main Methods:

• A retrospective study was conducted involving 194 patients undergoing 211 ERCP procedures at a Brazilian hospital.
• Patients with surgically altered anatomy were excluded from the analysis.
• Multivariate analysis was employed to identify predictors of early complications.

Main Results:

• The study identified six significant predictors for early post-ERCP complications: fistulotomy precut, difficult cannulation, attending's procedural time, choledocholithiasis, cannulation time, and ERCP duration.
• Early complication rates were 16%, with specific procedural factors significantly increasing this risk.
• Therapeutic success was high (97.6%), but technical failure occurred in 8.0% of cases.

Conclusions:

• Six key risk factors for post-ERCP early complications were identified, offering insights for prevention strategies.
• ERCP duration and cannulation time emerged as significant predictors and are proposed as novel quality indicators for ERCP.
• The findings emphasize the importance of careful procedural technique and patient selection to minimize ERCP-related adverse events.