The ASGE grading system for ERCP can predict success and complication rates in a tertiary referral hospital

Sahar, Nadav; Selva, Danielle La; Glück, Michael; Gan, S. Ian; Irani, Shayan; Larsen, Michael; Ross, Andrew; Kozarek, Richard A.

doi:10.1007/s00464-018-6317-7

Cited by 27 publications

(28 citation statements)

References 12 publications

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“…Based on the indication for ERCP, the ASGE assigns tiers of difficulty which may be useful to providers of varying expertise. 19,20 Indication relates to risk of adverse events; therefore, consistent documentation of ERCP indication across a group of providers is critically important to tracking provider case selection in comparison to peers. For example, what proportion of cases are performed for sphincter of Oddi disorders?…”

Section: Discussionmentioning

confidence: 99%

Development of an Automated ERCP Quality Report Card Using Structured Data Fields

Coté

Elmunzer

Förster

et al. 2021

Techniques and Innovations in Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

Development of an Automated ERCP Quality Report Card Using Structured Data Fields

Coté

Elmunzer

Förster

et al. 2021

Techniques and Innovations in Gastrointestinal Endoscopy

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“…Many studies have already used a grading system to assess the technical difficulty of ERCP. 7 , 10 , 16 , 17 We also used a grading scale to analyze the degree of difficulty of ERCP in Group II. Grade 2 was seen in 11 patients, grade 4 in 19, and grade 5 in only 1.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of laparoscopic common bile duct exploration (LCBDE) after failed endoscopic retrograde cholangiopancreatography versus primary LCBDE for managing cholecystocholedocholithiasis

et al. 2020

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Objective This study was performed to compare the outcomes of laparoscopic common bile duct exploration (LCBDE) after failed endoscopic retrograde cholangiopancreatography (ERCP) versus primary LCBDE for managing cholecystocholedocholithiasis. Methods We retrospectively analyzed data from 59 patients who underwent LCBDE during laparoscopic cholecystectomy (LC) for managing cholecystocholedocholithiasis from January 2013 to August 2019. The patients underwent either primary LCBDE plus LC (Group I) or LCBDE plus LC after failed ERCP (Group II). The demographics, reason for ERCP failure, perioperative details, and postoperative outcomes were evaluated. Results CBD stone removal using preoperative ERCP failed in 31 patients (Group II) because of remaining stones after ERCP (n = 9), failed cannulation (n = 6), failed sedation (n = 6), a periampullary diverticulum (n = 5), previous Billroth II gastrectomy (n = 3), a huge stone (n = 1), and an impacted stone (n = 1). The CBD stone clearance rate was >96% in both groups. The mean operative time, hospital stay, overall complication rate, and open conversion rate were not significantly different between the two groups. Conclusions When extraction of CBD stones by ERCP is likely to be difficult or fail, primary LCBDE is an acceptable alternative treatment for managing cholecystocholedocholithiasis.

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“…ERCP is associated with several possible complications, including post-procedural bleeding, perforations, pancreatitis and cholangitis; their incidence largely depends on the complexity of the procedure, which can be assessed by various scoring classifications (i.e . the American Society for Gastrointestinal Endoscopy (ASGE) grading system)[20,21].…”

Section: What Has Changed In the Past Few Years?mentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography, lights, and shadows: Handle with care

Salerno¹,

Mezzina²,

Ardizzone³

2019

WJGE

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The role of endoscopic retrograde cholangiopancreatography (ERCP) has dramatically changed in the last years, mainly into that of a therapeutic procedure. The treatment of benign biliary disease, like “difficult” choledocolithiasis, with endoscopic papillary large balloon dilation combined with endoscopic sphinterotomy has proven an effective and safe technique. Moreover, safety in ERCP has improved as well, with the prevention of post-ERCP pancreatitis and patient-to-patient transmission of infections. The advent of self-expandable metal stenting has radically changed the management of biliopancreatic malignant strictures, while the role for therapy of benign strictures is still controversial. In addition, cholangioscopy (though the direct visualization of the biliopancreatic ductal system) has allowed for characterization of indeterminate biliary strictures and facilitated rescue therapy of large biliary stones deemed removable. Encouraging data from tissue ablation techniques, such as photodynamic therapy and radiofrequency ablation, need to be confirmed by large sample size clinical controlled trials. On the other hand, we have no drug-coated stents yet available to implant and evidence for the use of biodegradable stents is still weak. The competency and privileging of ERCP and endoscopic ultrasonography have been analyzed longer but the switch between the two procedures, at the same time, is becoming ordinary; as such, the endoscopist interested in this field should undergo parallel edification through training plans. Finally, the American Society for Gastrointestinal Endoscopy’s statement on non-anesthesiologist administration of propofol for gastrointestinal endoscopy is not actually endorsed by the European Society of Anaesthesiology, having many medical-legal implications in some European countries.

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The ASGE grading system for ERCP can predict success and complication rates in a tertiary referral hospital

Cited by 27 publications

References 12 publications

Development of an Automated ERCP Quality Report Card Using Structured Data Fields

Development of an Automated ERCP Quality Report Card Using Structured Data Fields

Outcomes of laparoscopic common bile duct exploration (LCBDE) after failed endoscopic retrograde cholangiopancreatography versus primary LCBDE for managing cholecystocholedocholithiasis

Endoscopic retrograde cholangiopancreatography, lights, and shadows: Handle with care

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