Clin Endosc.  2023 May;56(3):290-297. 10.5946/ce.2022.210.

Quality indicators in endoscopic retrograde cholangiopancreatography: a brief review of established guidelines

Affiliations
  • 1Institute of Digestive and Hepatobiliary Sciences, Medanta Medicity, Gurugram, India

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic technique that has many diagnostic and therapeutic implications. It is a procedure with small but significant life-threatening complications. To ensure the best possible care, minimize complications, and improve the quality of health care, a constant review of the performance of the operator using ideal benchmark standards is needed. Hence, quality indicators are necessary. The American and European Societies of Gastrointestinal Endoscopy have provided guidelines on quality measures for ERCP, which describe the skills to be developed and training to be implemented in performing quality ERCP. These guidelines have divided the indicators into pre-procedure, intraprocedural, and post-procedure measures. The focus of this article was to review the quality indicators of ERCP.

Keyword

Benchmark; Cholangiopancreatography, endoscopic retrograde; Endoscopy; Healthcare; Quality indicators; Training

Reference

1. Kozarek RA. The past, present, and future of endoscopic retrograde cholangiopancreatography. Gastroenterol Hepatol (N Y). 2017; 13:620–622.
2. ASGE Endoscopy Unit Quality Indicator Taskforce, Day LW, Cohen J, et al. Quality indicators for gastrointestinal endoscopy units. VideoGIE. 2017; 2:119–140.
3. Adler DG, Lieb JG 2nd, Cohen J, et al. Quality indicators for ERCP. Am J Gastroenterol. 2015; 110:91–101.
4. Baron TH, Petersen BT, Mergener K, et al. Quality indicators for endoscopic retrograde cholangiopancreatography. Am J Gastroenterol. 2006; 101:892–897.
5. Chutkan RK, Ahmad AS, Cohen J, et al. ERCP core curriculum. Gastrointest Endosc. 2006; 63:361–376.
6. Rizk MK, Sawhney MS, Cohen J, et al. Quality indicators common to all GI endoscopic procedures. Gastrointest Endosc. 2015; 81:3–16.
7. Dumonceau JM, Kapral C, Aabakken L, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2020; 52:127–149.
8. Alkhatib AA, Hilden K, Adler DG. Comorbidities, sphincterotomy, and balloon dilation predict post-ERCP adverse events in PSC patients: operator experience is protective. Dig Dis Sci. 2011; 56:3685–3688.
9. Triantafillidis JK, Merikas E, Nikolakis D, et al. Sedation in gastrointestinal endoscopy: current issues. World J Gastroenterol. 2013; 19:463–481.
10. Kapral C, Duller C, Wewalka F, et al. Case volume and outcome of endoscopic retrograde cholangiopancreatography: results of a nationwide Austrian benchmarking project. Endoscopy. 2008; 40:625–630.
11. DeBenedet AT, Elmunzer BJ, McCarthy ST, et al. Intraprocedural quality in endoscopic retrograde cholangiopancreatography: a meta-analysis. Am J Gastroenterol. 2013; 108:1696–1704. quiz 1705.
12. Ekkelenkamp VE, Koch AD, Haringsma J, et al. Quality evaluation through self-assessment: a novel method to gain insight into ERCP performance. Frontline Gastroenterol. 2014; 5:10–16.
13. Schlup MM, Williams SM, Barbezat GO. ERCP: a review of technical competency and workload in a small unit. Gastrointest Endosc. 1997; 46:48–52.
14. Siau K, Keane MG, Steed H, et al. UK Joint Advisory Group consensus statements for training and certification in endoscopic retrograde cholangiopancreatography. Endosc Int Open. 2022; 10:E37–E49.
15. Verma D, Gostout CJ, Petersen BT, et al. Establishing a true assessment of endoscopic competence in ERCP during training and beyond: a single-operator learning curve for deep biliary cannulation in patients with native papillary anatomy. Gastrointest Endosc. 2007; 65:394–400.
16. Szary NM, Al-Kawas FH. Complications of endoscopic retrograde cholangiopancreatography: how to avoid and manage them. Gastroenterol Hepatol (N Y). 2013; 9:496–504.
17. Carr-Locke DL. Therapeutic role of ERCP in the management of suspected common bile duct stones. Gastrointest Endosc. 2002; 56(6 Suppl):S170–S174.
18. Banerjee N, Hilden K, Baron TH, et al. Endoscopic biliary sphincterotomy is not required for transpapillary SEMS placement for biliary obstruction. Dig Dis Sci. 2011; 56:591–595.
19. Stapfer M, Selby RR, Stain SC, et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg. 2000; 232:191–198.
20. Cotton PB, Eisen G, Romagnuolo J, et al. Grading the complexity of endoscopic procedures: results of an ASGE working party. Gastrointest Endosc. 2011; 73:868–874.
21. Cotton PB, Garrow DA, Gallagher J, et al. Risk factors for complications after ERCP: a multivariate analysis of 11,497 procedures over 12 years. Gastrointest Endosc. 2009; 70:80–88.
22. Domagk D, Oppong KW, Aabakken L, et al. Performance measures for ERCP and endoscopic ultrasound: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy. 2018; 50:1116–1127.
23. Cotton PB, Romagnuolo J, Faigel DO, et al. The ERCP quality network: a pilot study of benchmarking practice and performance. Am J Med Qual. 2013; 28:256–260.
24. Rodrigues-Pinto E, Macedo G, Baron TH. ERCP competence assessment: miles to go before standardization. Endosc Int Open. 2017; 5:E718–E721.
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