Performance measures for endoscopic retrograde cholangiopancreatography and endoscopic ultrasound: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative

Abstract

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a short list of key performance measures for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). We recommend that endoscopy services across Europe adopt the following seven key and one minor performance measures for EUS and ERCP, for measurement and evaluation in daily practice at centre and endoscopist level: 1 Adequate antibiotic prophylaxis before ERCP (key performance measure, at least 90%); 2 antibiotic prophylaxis before EUS-guided puncture of cystic lesions (key performance measure, at least 95%); 3 bile duct cannulation rate (key performance measure, at least 90%); 4 tissue sampling during EUS (key performance measure, at least 85%); 5 appropriate stent placement in patients with biliary obstruction below the hilum (key performance measure, at least 95%); 6 bile duct stone extraction /home/ueg (key performance measure, at least 90%); 7 post-ERCP pancreatitis (key performance measure, less than 10%); and 8 adequate documentation of EUS landmarks (minor performance measure, at least 90%).This present list of quality performance measures for ERCP and EUS recommended by the ESGE should not be considered to be exhaustive; it might be extended in future to address further clinical and scientific issues.

Curriculum for small-bowel capsule endoscopy and device-assisted enteroscopy training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

“…formed during a training period. In the case of ERCP, this is the ability to cannulate the bile duct in at least 90 % of cases [80]. This has also been applied to training in colonoscopy, where the cecal intubation rate is considered to be an important aspect of training, independent of the number of colonoscopies performed [81].…”

Macroscopic appearance of the major duodenal papilla influences bile duct cannulation: a prospective multicenter study by the Scandinavian Association for Digestive Endoscopy Study Group for ERCP

“…endoscopist to a varying degree, it can be used as an intraprocedural quality measure along with failed cannulation frequency 20,21 . Further studies regarding this might determine a benchmark for what frequency of difficult cannulation one should accomplish and maintain to be considered a qualified ERCP endoscopist.…”

Setting the stage for research in endoscopy

“…The digital revolution has brought relevant innovations with respect to early detection and better endoscopic diagnosis. 1 In addition to diagnostic endoscopy, interventional endoscopy is gaining increasing interest; not least due to the growing public demand for minimal invasiveness. 2 In the near future, more endoscopic intraluminal interventions will therefore be performed, requiring an increasing number of practicing endoscopists.…”