Current ERCP practice in Belgium: the BSGIE survey

Area of Science:

• Gastroenterology
• Endoscopy
• Medical Quality Improvement

Background:

• Data on procedural outcomes and quality of endoscopic retrograde cholangiopancreatography (ERCP) in Belgium are limited.
• Assessing the current status of ERCP performance in Belgian practice is crucial for quality improvement.

Purpose of the Study:

• To evaluate the current performance and quality standards of ERCP procedures in Belgium.
• To identify variations in ERCP practices among Belgian healthcare institutions.

Main Methods:

• A national multi-institutional survey was conducted among members of the Belgian Society of Gastrointestinal Endoscopy (BSGIE).
• Online questionnaires gathered data on ERCP procedures, center volumes, endoscopist experience, and adherence to protocols.
• Real-world data on total ERCPs performed in Belgium were obtained from RIZIV/INAMI.

Main Results:

• Forty-five centers (43% of Belgian institutions) participated, covering 8368 ERCPs.
• Most centers performed over 100 ERCPs annually, but low-volume centers were underrepresented.
• Stone extraction was the most common indication (52%); 74% of endoscopists had over 10 years of experience.
• Protocols for duodenoscope surveillance were common (84%), but monitoring of cannulation rates and post-ERCP pancreatitis (PEP) was limited (30%).
• NSAIDs were used for PEP prophylaxis in 65% of centers.

Conclusions:

• This is the first survey detailing ERCP performance in Belgium, highlighting significant practice variations.
• Adherence to key performance measures and systematic evaluation of ERCP performance are not uniformly implemented.
• Further standardization and quality monitoring are needed to improve ERCP outcomes in Belgium.