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DOI: 10.1055/s-0041-1724372
Influence of the Number of Endoscopists Performing ERCP on the Outcomes of the Procedure
Aims To evaluate the impact of the number of endoscopists performing ERCP on the outcomes of this procedure in our hospital.
Methods From september 2013 until august 2015 ERCP was performed by 5 endoscopists in our hospital (period I), from september 2015 until december 2017 by 4 (period II) and from January 2018 until june 2020 by 3 (period III). A retrospective analysis of a prospectively filled database comparing the outcomes of ERCP in those periods was made. Patients with biliary ERCP and native papilla were included. EUS guided biliary drainage procedures were excluded. The main variables compared were cannulation and adverse effects (AE) rates. The higher complexity of the procedure according to the ASGE classification was measured, considering levels III and IV as high complex procedures. Individual outcomes of the endoscopists were analyzed.
Results A total of 2156 patients fulfilled inclusion criteria: 727 (period I), 972 (period II) and 862 (period III). Patients mean age was 70.71 ± 15.9, 70.32 ± 15.6 and 71.32 ± 15.4, respectively (p>0.05). Combined ERCP and diagnostic EUS were performed in 8.1 %, 14.9 % and 20.15 %, respectively (p<0.05). The proportion of high complex procedures was 12 %, 14.8 % and 27 % (p < 0.0001), respectively. The cannulation rate was significantly higher in periods II and III: 92.4 % vs 93.3 % vs 93 % (p = 0.037). The AE rate was 13.8 %, 12.6 % and 10.3 % (p>0.05). Post-ERCP pancreatitis rate was significantly lower in period III: 8.5 %, 7.3 % and 5 % (p = 0.01). Only two endoscopists participated in all periods ([Table I]).
|
Endoscopist |
ERCP, n (I vs II vs III, p) |
Cannulation Rate (%) |
Total AE Rate (%) |
Post-ERCP Pancreatitis Rate |
|---|---|---|---|---|
|
Endoscopist 1 |
113 vs 326 vs 353, p = 0.001 |
89.4 % vs 95.4 % vs 96 %, p = 0.01 |
11.5 % vs 12 % vs 8.2 %, p = 0.243 |
5.3 % vs 5.2 % vs 3.4 %, p = 0.456 |
|
Endoscopist 2 |
109 vs 251 vs 265, p = 0.02 |
93.6 % vs 92 % vs 94.7 %, p = 0.468 |
13.8 % vs 12 % vs 15.5 %, p = 0.5 |
9.2 % vs 8.4 % vs 8.7 %, p = 0.9 |
With logistic regression, the cannulation and post-ERCP pancreatitis rates remained significantly better in period III after adjusting for sex, complexity and endoscopist.
Conclusions The lower number of endoscopists performing ERCP was associated with a higher rate of cannulation and a lower rate of post-ERCP pancreatitis, despite the greater complexity of the procedures. These beneficial effects seems to difer between endoscopists.
Citation: Arrubla A, Rodríguez Mendiluce I, Hervas N et al. OP113 INFLUENCE OF THE NUMBER OF ENDOSCOPISTS PERFORMING ERCP ON THE OUTCOMES OF THE PROCEDURE. Endoscopy 2021; 53: S48.
Publication History
Article published online:
19 March 2021
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