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Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study

BACKGROUND/AIMS: Few studies have addressed the relationship between the occurrence of adverse events (AEs) in endoscopic retrograde cholangiopancreatography (ERCP) and hospital case volume or endoscopist’s experience with inconsistent results. The aim of our study was to investigate the impact of h...

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Autores principales: Lee, Hyun Jik, Cho, Chang Min, Heo, Jun, Jung, Min Kyu, Kim, Tae Nyeun, Kim, Kook Hyun, Kim, Hyunsoo, Cho, Kwang Bum, Kim, Ho Gak, Han, Jimin, Lee, Dong Wook, Lee, Yoon Suk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial Office of Gut and Liver 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096235/
https://www.ncbi.nlm.nih.gov/pubmed/31060119
http://dx.doi.org/10.5009/gnl18537
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author Lee, Hyun Jik
Cho, Chang Min
Heo, Jun
Jung, Min Kyu
Kim, Tae Nyeun
Kim, Kook Hyun
Kim, Hyunsoo
Cho, Kwang Bum
Kim, Ho Gak
Han, Jimin
Lee, Dong Wook
Lee, Yoon Suk
author_facet Lee, Hyun Jik
Cho, Chang Min
Heo, Jun
Jung, Min Kyu
Kim, Tae Nyeun
Kim, Kook Hyun
Kim, Hyunsoo
Cho, Kwang Bum
Kim, Ho Gak
Han, Jimin
Lee, Dong Wook
Lee, Yoon Suk
author_sort Lee, Hyun Jik
collection PubMed
description BACKGROUND/AIMS: Few studies have addressed the relationship between the occurrence of adverse events (AEs) in endoscopic retrograde cholangiopancreatography (ERCP) and hospital case volume or endoscopist’s experience with inconsistent results. The aim of our study was to investigate the impact of hospital case volume and endoscopist’s experience on the AEs associated with ERCP and to analyze patient- and procedure-related risk factors for post-ERCP AEs. METHODS: From January 2015 to December 2015, we prospectively enrolled patients with naïve papilla who underwent ERCP at six centers. Patient- and procedure-related variables were recorded on data collection sheets at the time of and after ERCP. RESULTS: A total of 1,191 patients (median age, 71 years) were consecutively enrolled. The overall success rate of biliary cannulation was 96.6%. Overall, 244 patients (20.5%) experienced post-ERCP AEs, including pancreatitis (9.0%), bleeding (11.8%), perforation (0.4%), cholangitis (1.2%), and others (0.9%). While post-ERCP pancreatitis (PEP) was more common when the procedure was performed by less experienced endoscopists, bleeding was more common in high-volume centers and by less experienced endoscopists. Multivariate analysis showed that a less experience in ERCP was significantly associated with PEP (odds ratio [OR], 1.630; 95% confidence interval [CI], 1.050 to 2.531; p=0.030) and post-ERCP bleeding (OR, 1.439; 95% CI, 1.003 to 2.062; p=0.048). CONCLUSIONS: Our study demonstrated that overall AEs following ERCP were associated with the experience of the endoscopist. To minimize post-ERCP AEs, rigorous training with a sufficient case volume is required, and treatment strategies should be modified according to the endoscopist’s expertise.
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spelling pubmed-70962352020-04-02 Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study Lee, Hyun Jik Cho, Chang Min Heo, Jun Jung, Min Kyu Kim, Tae Nyeun Kim, Kook Hyun Kim, Hyunsoo Cho, Kwang Bum Kim, Ho Gak Han, Jimin Lee, Dong Wook Lee, Yoon Suk Gut Liver Original Article BACKGROUND/AIMS: Few studies have addressed the relationship between the occurrence of adverse events (AEs) in endoscopic retrograde cholangiopancreatography (ERCP) and hospital case volume or endoscopist’s experience with inconsistent results. The aim of our study was to investigate the impact of hospital case volume and endoscopist’s experience on the AEs associated with ERCP and to analyze patient- and procedure-related risk factors for post-ERCP AEs. METHODS: From January 2015 to December 2015, we prospectively enrolled patients with naïve papilla who underwent ERCP at six centers. Patient- and procedure-related variables were recorded on data collection sheets at the time of and after ERCP. RESULTS: A total of 1,191 patients (median age, 71 years) were consecutively enrolled. The overall success rate of biliary cannulation was 96.6%. Overall, 244 patients (20.5%) experienced post-ERCP AEs, including pancreatitis (9.0%), bleeding (11.8%), perforation (0.4%), cholangitis (1.2%), and others (0.9%). While post-ERCP pancreatitis (PEP) was more common when the procedure was performed by less experienced endoscopists, bleeding was more common in high-volume centers and by less experienced endoscopists. Multivariate analysis showed that a less experience in ERCP was significantly associated with PEP (odds ratio [OR], 1.630; 95% confidence interval [CI], 1.050 to 2.531; p=0.030) and post-ERCP bleeding (OR, 1.439; 95% CI, 1.003 to 2.062; p=0.048). CONCLUSIONS: Our study demonstrated that overall AEs following ERCP were associated with the experience of the endoscopist. To minimize post-ERCP AEs, rigorous training with a sufficient case volume is required, and treatment strategies should be modified according to the endoscopist’s expertise. Editorial Office of Gut and Liver 2020-03-15 2020-01-07 /pmc/articles/PMC7096235/ /pubmed/31060119 http://dx.doi.org/10.5009/gnl18537 Text en Copyright © 2020 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Hyun Jik
Cho, Chang Min
Heo, Jun
Jung, Min Kyu
Kim, Tae Nyeun
Kim, Kook Hyun
Kim, Hyunsoo
Cho, Kwang Bum
Kim, Ho Gak
Han, Jimin
Lee, Dong Wook
Lee, Yoon Suk
Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study
title Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study
title_full Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study
title_fullStr Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study
title_full_unstemmed Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study
title_short Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study
title_sort impact of hospital volume and the experience of endoscopist on adverse events related to endoscopic retrograde cholangiopancreatography: a prospective observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096235/
https://www.ncbi.nlm.nih.gov/pubmed/31060119
http://dx.doi.org/10.5009/gnl18537
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