Year 2018 / Volume 110 / Number 10
Special Article
Quality indicators for endoscopic retrograde cholangiopancreatography. The procedure of endoscopic retrograde cholangiopancreatography

658-666

DOI: 10.17235/reed.2018.5652/2018

Fernando Alberca de las Parras, Julio López-Picazo, Shirley Pérez Romero, Antonio Sánchez del Río, Javier Júdez Gutiérrez, Joaquín León Molina,

Abstract
The goal of the project encompassing the present paper is to propose useful quality procedures and indicators in order to improve quality in digestive endoscopy units. In this third part outcome procedures and indicators are suggested for endoscopic retrograde cholangiopancreatography (ERCP). First, a diagram of pre- and post-ERCP steps was developed. A group of experts in healthcare quality and/or endoscopy, under the shelter of the Spanish Society of Digestive Diseases (Sociedad Española de Patología Digestiva - SEPD), carried out a qualitative review of the literature regarding quality indicators for ERCP. Then, a paired analysis was used for the selection of identified references. A total of six specific indicators, apart from the common indicators already described, were identified, all of them process indicators (two pre-procedure and four post-procedure). Evidence quality was analyzed for each indicator using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) classification.
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References
1. Conklin LS, Bernstein C, Bartholomew L et al. Medical practice in gastroenterology. Clin. Gastroenterol. Hepatol. 6(6), 677–681 (2008)
2. Cotton PB. Twenty more ERCP lawsuits: why? Poor indications and communications. Gastrointest. Endosc 2010. 72(4), 904.
3. Donabedian A. Basic approaches to assessment: What to assess. Exploration, structure, process and outcomes - Quality assessment and monitoring. Vol. 1. Michigan: Health Administration Press Ann Arbor; 1980. pp. 79-122.
4. López-Picazo J, Alberca-de-las-Parras F, Sánchez-del-Río A et al. Quality indicators in digestive endoscopy: introduction to structure, process, and outcome common indicators. Rev Esp Enferm Dig 2016;109(4):435-450. DOI: 10.17235/reed.2017.5035/2017
5. Sánchez-del-Río A, Pérez-Romero S, López-Picazo J et al. Indicadores de calidad en colonoscopia. Procedimiento de la colonoscopia. Rev Esp Enferm Dig 2018;110(5) (in press)
6. Atkins D, Eccles M, Flottorp S et al. Systems for grading th e quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res 2004;4(1):38. DOI: 10.1186/1472-6963-4-38
7. Atkins D, Briss PA, Eccles M, et al. Systems for grading the quality of evidence and the strength of recommendations II: Pilot study of a new system. BMC Health Serv Res 2005;5(1):25.
8. Adler DG, Lien II JG, Cohen J et al. ASGE/ACG Task Force on quality in endoscope. Quality indicators for ERCP. Gastrointest Endosc 2015; 81:54-66
9. Alkhatib AA, Hilden K, Adler DG. Comorbidities, sphincterotomy, and balloon dilation predict post-ERCP adverse events in PSC patients: operator experience is protective. Dig Dis Sci 2011;56:3685-8
10. Brand M, Bizos D, O'Farrell PJR. Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography. Cochrane Database of Systematic Reviews 2010, Issue 10. Art. No.: CD007345. DOI: 10.1002/14651858.CD007345.pub2
11. Khashab MA, Chithadi KV, Acosta RD et al. ASGE Standards of Practice Committee. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc. 2015 Jan;81(1):81-9
12. Schutz SM & Abbott RM. Grading ERCPs by degree of difficulty: a new concept to produce more meaningful outcome data. Gastrointest Endosc 2000; 51: 535–539
13. Ekkelenkamp VE, Koch AD, Haringsma J et al. Quality evaluation through self-assessment: a novel method to gain insight into ERCP performance. Frontline Gastroenterol 2014; 5: 10–16
14. Cotton PB. Income and outcome metrics for the objective evaluation of ERCP and alternative methods. Gastrointest Endosc 2002;56(Suppl 6):S283–90
15. Baron T,Petersen B, Mergener K et al. ASGE/ACG Taskforce on Quality in Endoscopy. Quality Indicators for Endoscopic Retrograde Cholangiopancreatography. Am J Gastroenterol 2006;101:892–897
16. Cotton PB, Eisen G, Romagnuolo J et al. Grading the complexity of endoscopic procedures: results of an ASGE working party. Gastrointest. Endosc. 73(8), 868–874 (2011))
17. DeBenedet AT, Elmunzer BJ, McCarthy ST et al. Intraprocedural quality in endoscopic retrograde cholangiopancreatography: a meta-analysis. Am J Gastroenterol. 2013 Nov;108(11):1696-704; quiz 705. PubMed PMID: 23877349. PMCID: PMC3840532. Eng
18. Kapral C, Duller C, Wewalka F et al. Case volume and outcome of endoscopic retrograde cholangiopancreatography: results of a nationwide Austrian benchmarking project. Endoscopy 2008; 40: 625–630.
19. Testoni PA, Mariani A, Aabakken L et al. Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016. doi: 10.1055 / s-0042-108641
20. Halttunen J, Meisner S, Aabakken L et al. Difficult cannulation as defined by a prospective study of the Scandinavian Association for Digestive Endoscopy (SADE) in 907 ERCPs. Scand J Gastroenterol 2014; 49: 752–758).
21. Maple JT, Ben-Menachem T, Anderson MA et al. The role of endoscopy in the evaluation of suspected choledocholithiasis. Gastrointestinal Endoscopy. 2010 Jan;71(1):1-9. PubMed PMID: WOS:000273772400001
22. Maple JT, Ikenberry SO, Anderson MA et al. The role of endoscopy in the management of choledocholithiasis. Gastrointestinal Endoscopy. 2011 Oct;74(4):731-44. PubMed PMID: WOS:000295963900001
23. Banerjee N, Hilden K, Baron TH et al. Endoscopic biliary sphincterotomy is not required for transpapillary SEMS placement for biliary obstruction. Dig Dis Sci 2011;56:591-5.
24. Kachaamy T, Harrison E, Pannala R et al. Measures of patient radiation exposure during endoscopic retrograde cholangiography: beyond fluoroscopy time. World J Gastroenterol. 2015 Feb 14;21(6):1900-6
25. Romagnuolo J, Cotton PB. Recording ERCP fluoroscopy metrics using a multinational quality network: establishing benchmarks and examining time-related improvements. Am J Gastroenterol 2013; 108: 1224-1230
26. Barakat MT, Thosani NC, Huang RJ et al. Effects of a Brief Educational Program on Optimization of Fluoroscopy to Minimize Radiation Exposure During Endoscopic Retrograde Cholangiopancreatography. Clin Gastroenterol Hepatol. 2017 Aug 10. pii: S1542-3565(17)30937-0. doi: 10.1016/j.cgh.2017.08.008. En prensa. Disponible en https://www.clinicalkey.es/!/content/journal/1-s2.0-S1542356517309370. Consultado el 13/12/2017.
27. Stecker MS, Balter S, Towbin RB et al. Guidelines for patient radiation dose management. J Vasc Interv Radiol 2009; 20: S263-S273
28. Cotton PB, Lehman G, Vennes J et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 1991;37:383-93
29. Kachaamy TA, Faigel DO. Improving ERCP quality and decreasing risk to patients and providers. Expert Rev Gastroenterol Hepatol. 2013;7(6):531–540
30. Freeman ML, Guda NM. Prevention of post-ERCP pancreatitis: a comprehensive review. Gastrointest Endosc 2004;59:845-64
31. Cotton PB, Garrow DA, Gallagher J et al. Risk factors for complications after ERCP: a multivariate analysis of 11,497 procedures over 12 years. Gastrointest Endosc 2009;70:80-8
32. Anderson MA, Fisher L, Jain R et al. Complications of ERCP. Gastrointest Endosc 2012;75(3): 467-473
33. Montaño Loza A, Rodríguez Lomelí X, García Correa JE et al. Effect of the administration of rectal indomethacin on amylase serum levels after endoscopic retrograde cholangiopancreatography, and its impact on the development of secondary pancreatitis episodes [in Spanish]. Rev Esp Enferm Dig. 2007;99:330–336
34. Elmunzer BJ, Scheiman JM, Lehman GA et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med. 2012;366:1414–1422
35. Mazaki T, Masuda H, Takayama T. Prophylactic pancreatic stent placement and post-ERCP pancreatitis: a systematic review and metaanalysis. Endoscopy 2010;42:842-53
36. Alberca de las Parras F, Egea Valenzuela J, Carballo Álvarez F. Riesgo de sangrado en la colangiopancreatografía retrógrada endoscópica: impacto del uso de fármacos antitrombóticos. Rev Esp Enferm Dig 2017;109(3):202-210.DOI: 10.17235/reed.2017.4358/2016
37. Andriulli A, Loperfido S, Napolitano G et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol 2007;102:1781-8
38. Glomsaker T, Hoff G, Kvaløy JT et al; Norwegian Gastronet ERCP Group. Patterns and predictive factors of complications after endoscopic retrograde cholangiopancreatography. Br J Surg. 2013 Feb;100(3):373-80. doi: 10.1002/bjs.8992. Epub 2012 Dec 6
39. Huibregtse K, Katon RM, Tytgat GN. Precut papillotomy via fine-needle knife papillotome: a safe and effective technique. Gastrointest Endosc 1986; 32: 403-405
40. Balmadrid B, Kozarek R. Prevention and management of adverse events of endoscopic retrograde cholangiopancreatography. Gastrointest Endosc Clin N Am. 2013 Apr;23(2):385-403. doi: 10.1016/j.giec.2012.12.007
41. Veitch AM, Baglin TP, Gershlick AH et al. Guidelines for the management of anticoagulant endoscopic procedures and antiplatelet therapy in patients undergoing endoscopic procedures. Gut 2008;57;1322-9. DOI: 10.1136/gut.2007.142497
42. Becker RC, Scheiman J, Dauerman HL et al; American College of Cardiology and the American College of Gastroenterology. Management of platelet‑directed pharmacotherapy in patients with atherosclerotic coronary artery disease undergoing elective endoscopic gastrointestinal procedures. Am J Gastroenterol 2009;104:2903-17. DOI: 10.1038/ajg.2009.667
43. Alberca de las Parras F, Marín F, Roldán Schilling V et al. Manejo de los fármacos antitrombóticos asociados a los procedimientos endoscópicos. Rev Esp Enferm Dig 2015;107:289-306).
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Alberca de las Parras F, López-Picazo J, Pérez Romero S, Sánchez del Río A, Júdez Gutiérrez J, León Molina J, et all. Quality indicators for endoscopic retrograde cholangiopancreatography. The procedure of endoscopic retrograde cholangiopancreatography . 5652/2018


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Publication history

Received: 13/04/2018

Accepted: 01/07/2018

Online First: 03/08/2018

Published: 01/10/2018

Article revision time: 76 days

Article Online First time: 112 days

Article editing time: 171 days


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