ERCP PERFORMANCE IN A TERTIARY BRAZILIAN CENTER: FOCUS ON NEW RISK FACTORS, COMPLICATIONS AND QUALITY INDICATORS

Autor: Stella Maria Torres Furlani, Marcelo de Sousa Cury, Alana Costa Borges, Paulo César de Almeida, Douglas K. Pleskow
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Indicadores de qualidade em assistência à saúde
Multivariate analysis
Adolescent
RD1-811
Technical failure
MEDLINE
Endoscopy
gastrointestinal
RC799-869
Fistulotomy
Complicações pós-operatórias
Tertiary Care Centers
Young Adult
03 medical and health sciences
Postoperative complications
0302 clinical medicine
medicine
Humans
Young adult
Aged
Quality Indicators
Health Care
Retrospective Studies
Aged
80 and over
Cholangiopancreatography
Endoscopic Retrograde
Fatores de risco
business.industry
Retrospective cohort study
General Medicine
Middle Aged
Diseases of the digestive system. Gastroenterology
Surgery
Risk factors
030220 oncology & carcinogenesis
Endoscopia do sistema digestório
Original Article
Female
030211 gastroenterology & hepatology
Observational study
Qualityindicators
healthcare
business
Single session
Brazil
Zdroj: ABCD: Arquivos Brasileiros de Cirurgia Digestiva, Vol 31, Iss 1 (2018)
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.31 n.1 2018
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
Colégio Brasileiro de Cirurgia Digestiva (CBCD)
instacron:CBCD
Arquivos Brasileiros de Cirurgia Digestiva : ABCD
ISSN: 0102-6720
Popis: Background: ERCP can lead to complications, which can be prevented by the recognition of risk factors. Aim: To identify these risk factors, with quality evaluation. Methods: Retrospective study in a Brazilian hospital in 194 patients, excluding surgically altered anatomy. Results: 211 ERCPs were performed: 97.6% were therapeutic, 83.4% were started by trainees, with deep cannulation rate of 89.6%. Precut was needed in 16.6% of the ERCPs and classic sphincterotomy in 67.3%, with 75.4% of ductal clearance at single session and 8.0% of technical failure. Inacessible papillas ocurred in 2.5% of cases. There were 2.5% of late complications and 16% of early complications. Multivariate analysis identified six predictors for early complications: fistulotomy precut (OR=3.4, p=0.010), difficult cannulation (OR=21.5, p=0.002), attending’s procedural time (OR=2.4, p=0.020), choledocholithiasis (adjusted OR=1.8, p=0.015), cannulation time (adjusted OR=3.2, p=0.018) and ERCP duration (adjusted OR=2.7, p=0.041). Conclusion: Six risk factors for post-ERCP complications were identified. ERCP duration and cannulation time are suggested as new potential quality indicators.
Databáze: OpenAIRE
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