Impact of center and endoscopist ERCP volume on ERCP outcomes: a systematic review and meta-analysis

Campos, Sara; Papaefthymiou, Apostolis; Florou, Theodosia; Facciorusso, Antonio; Arvanitakis, Marianna; Devière, Jacques; Gkolfakis, Paraskevas

doi:10.1016/j.gie.2023.05.045

Cited by 19 publications

(2 citation statements)

References 54 publications

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“…Among individual complications, the bleeding rate was significantly lower in the HV group, whereas the PEP rate was not (OR 0.76, 95%CI 0.53-1.09 for endoscopists; OR 0.84, 95%CI 0.63-1.12 for centers). The cutoff value to define LV endoscopists or centers varied widely among the included studies, but a sensitivity analysis using 200 procedures as a threshold resulted in similar outcomes [ 31 ]. Interestingly, these findings were not confirmed in a pediatric population.…”

Section: New Strategies Of Prophylaxis Since the Updated Esge Guidelinementioning

confidence: 99%

Update in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis

Gellért

2024

aog

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Of all the possible complications associated with endoscopic retrograde cholangiopancreatography (ERCP), acute pancreatitis undoubtedly represents the heaviest burden for patients and healthcare professionals. The overall incidence, ranging from 3.5% to around 10%, and annual estimated costs exceeding $150 million in the USA should signal caution for everyone carrying out ERCP. In-depth knowledge of the risk factors and the pharmacological and endoscopic treatment options is required to avoid this adverse event. In this review, we evaluate the relevant data published in the literature since the appearance of the latest recommendations of the leading gastroenterological societies. Thus, we intend to provide a comprehensive and up-to-date overview of the factors to consider and possible interventions applicable before and after the intervention to prevent the development of post-ERCP pancreatitis.

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Section: New Strategies Of Prophylaxis Since the Updated Esge Guidelinementioning

confidence: 99%

Update in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis

Gellért

2024

aog

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“…However, there is a considerable risk of ERCP-related adverse events, the most important ones being post-ERCP pancreatitis and cholangitis, post-sphincterotomy bleeding and perforation [2]. Therefore, ERCP requires rigorous and continuous training [3]. Apart from the risks related to the endoscopic intervention, the use of fluoroscopy during the procedure leads to potentially hazardous radiation exposure of both the patient and the medical staff involved in the procedure.…”

Section: Introductionmentioning

confidence: 99%

Patient Radiation Exposure during Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy (with Video)

Monino,

Moreels

2024

Diagnostics

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Background: Fluoroscopy must be used cautiously during endoscopic retrograde cholangiopancreatography (ERCP). Radiation exposure data in patients with surgically altered anatomy undergoing enteroscopy-assisted ERCP (EA-ERCP) are scarce. Methods: 34 consecutive EA-ERCP procedures were compared with 68 conventional ERCP (C-ERCP) procedures. Patient and procedure characteristics and radiation data were collected. Results: Surgical reconstructions were gastrojejunostomy, Roux-en-Y hepaticojejunostomy, Roux-en-Y total gastrectomy, Roux-en-Y gastric bypass and Whipple’s duodenopancreatectomy. Procedures were restricted to biliary indications. Mean fluoroscopy time was comparable in both groups (370 ± 30 s EA-ERCP vs. 393 ± 40 s C-ERCP, p = 0.7074), whereas total mean radiation dose was lower in EA-ERCP (83 ± 6 mGy) compared to C-ERCP (110 ± 11 mGy, p = 0.0491) and dose area product (DAP) was higher in EA-ERCP (2216 ± 173 µGy*m2) compared to C-ERCP (1600 ± 117 µGy*m2, p = 0.0038), as was total procedure time (77 ± 5 min vs. 39 ± 3 min, p < 0.0001). Enteroscope insertion to reach the bile duct during EA-ERCP took 28 ± 4 min, ranging from 4 to 90 min. These results indicate that C-ERCP procedures are generally more complex, needing magnified fluoroscopy, whereas EA-ERCP procedures take more time for enteroscope insertion under wide field fluoroscopic guidance (increased DAP) with less complex ERCP manipulation (lower total radiation dose). Conclusions: Radiation exposure during EA-ERCP in surgically altered anatomy is different as compared to C-ERCP. EA-ERCP takes longer with a higher DAP because of the enteroscope insertion, but with lower total radiation dose because these ERCP procedures are usually less complex.

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Implementation of a same‐day, round‐trip interventional endoscopy service for rural and critical access hospital patients

Suresh,

Nassani,

Servin‐Abad

et al. 2024

Journal of Hospital Medicine

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Impact of center and endoscopist ERCP volume on ERCP outcomes: a systematic review and meta-analysis

Cited by 19 publications

References 54 publications

Update in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis

Update in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis

Patient Radiation Exposure during Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy (with Video)

Implementation of a same‐day, round‐trip interventional endoscopy service for rural and critical access hospital patients

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