Efficacy and safety of ERCP in a low-volume hospital
| Autor: | Miguel Rivero-Fernández, Rebeca Manzano-Fernández, Antonio Díaz-Sánchez, Juana María Rizo-Pascual, Eloísa Moya-Valverde, Rocío Campos-Cantero, José María Riesco-López, Manuel Vázquez-Romero, Rosario González-Alonso |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Expert biliary endoscopist medicine.medical_specialty Hospitals Low-Volume Perforation (oil well) MEDLINE Endoscopic retrograde cholangiopancreatography (ERCP) Sphincterotomy medicine Humans Learning curve Aged Retrospective Studies Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry General surgery Gastroenterology Cirrhotic patient Retrospective cohort study General Medicine Middle Aged medicine.disease Low volume Biliary cannulation Acute pancreatitis Female Upper gastrointestinal bleeding business Learning Curve |
| Zdroj: | Revista Española de Enfermedades Digestivas v.105 n.2 2013 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
| ISSN: | 1130-0108 |
| DOI: | 10.4321/s1130-01082013000200002 |
| Popis: | Background and aims there is little scientific evidence on the outcomes of endoscopic retrograde cholangiopancreatography (ERCP) performed in low-volume hospitals; however, in our country, it is growing up its implementation. The objectives of our study were to evaluate the efficacy and safety of this technique performed by two endoscopists with basic training in a center of this nature and analyze the learning curve in the first procedures. Patients and methods single-center retrospective study of the first 200 ERCP performed in our hospital (analyzing the evolution between the first 100 and 100 following procedures), comparing them with the quality standards proposed in the literature. Results from February 2009 to April 2011, we performed 200 ERCP in 169 patients, and the most common indications were: Choledocholithiasis (77 %), tumors (14.5 %) and other conditions (8.5 %). The cannulation rate rose from 85 % in the first 100 ERCPto 89 % in the next 100 procedures, clinical success from 81 % to 87 %, decreasing the post-ERCP acute pancreatitis rate from 11 % to 4 %, upper gastrointestinal bleeding (UGIB) from 3 % to 2 % and acute cholangitis from 4 % to 1 %. There was a death from a massive UGIB in a cirrhotic patient in the first group of patients and a case of biliary perforation resolved by surgery in the second one. Conclusions the results obtained after performing 200 procedures support the ability to practice ERCP in low-volume hospitals obtaining levels of efficacy and safety in accordance with published quality standards. |
| Databáze: | OpenAIRE |
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