Prospective evaluation of ERCP performance in an Italian regional database study

Area of Science:

• Gastroenterology
• Endoscopy
• Health Services Research

Background:

• Studies on endoscopic retrograde cholangiopancreatography (ERCP) in community settings are limited.
• Assessing the real-world performance of ERCP is crucial for quality improvement.

Purpose of the Study:

• To evaluate the success and complication rates of routine ERCP procedures in a regional healthcare setting.
• To identify key quality indicators for ERCP practice.

Main Methods:

• A prospective, region-wide observational study was conducted over six months.
• Data on consecutive ERCP procedures were collected using a centralized online questionnaire.
• The study considered priority quality indicators set by the American Society of Gastrointestinal Endoscopy (ASGE).

Main Results:

• A total of 2388 ERCP procedures were performed by 38 endoscopists across 18 centers.
• The most frequent indications were choledocholithiasis (54.8%) and malignant jaundice (22.6%).
• Successful cannulation was achieved in 96% of cases, with an overall ERCP success rate of 91.1%.
• Complications occurred in 8.4% of procedures, including post-ERCP pancreatitis (4.1%), bleeding (2.9%), infection (0.8%), and perforation (0.4%).
• Mortality rate was 0.4%.
• ERCP success and difficulty were significantly associated with operator experience and center volume.
• All ASGE-recommended quality indicators were met.

Conclusions:

• A procedural questionnaire is an effective tool for evaluating ERCP quality in community settings.
• Routine ERCP in a regional setting demonstrates achievable success rates and manageable complication profiles.
• Operator experience and center volume are critical factors influencing ERCP outcomes.