Outcome of ERCP related to case-volume

Area of Science:

• Gastroenterology
• Hepatology
• Surgical Outcomes

Background:

• High case volume in endoscopic retrograde cholangiopancreatography (ERCP) is often associated with improved procedural success and reduced adverse events.
• The relationship between ERCP case-volumes and patient outcomes requires further investigation.

Purpose of the Study:

• To analyze the association between ERCP success rates and complication rates.
• To determine the impact of endoscopist and center case-volumes on ERCP outcomes.

Main Methods:

• Data from the Swedish National Register for Gallstone Surgery and ERCP (GallRiks) were analyzed for 17,873 cases of common bile duct stones and 6,152 cases of malignancy between 2009 and 2018.
• Successful cannulation, procedure time, and complication rates (including post-ERCP pancreatitis) were compared with endoscopist and center ERCP case-volumes from the preceding year.

Main Results:

• Higher endoscopist case-volume correlated with increased successful cannulation, decreased complications and post-ERCP pancreatitis (PEP), and shorter procedure times in the common bile duct stone group.
• High-volume centers showed higher successful cannulation and shorter procedure times but not necessarily lower complication or PEP rates.
• For malignancy indications, high endoscopist volume was linked to high success and low PEP rates, while high center volume was associated with high success and low complication/PEP rates.

Conclusions:

• Higher case-volumes for both individual endoscopists and medical centers are associated with improved success rates and better safety profiles in ERCP procedures.
• These findings underscore the importance of case volume in optimizing ERCP outcomes.