Year 2013 / Volume 105 / Number 2
Original
Efficacy and safety of ERCP in a low-volume hospital

pp. 68-73-

José María Riesco López, Manuel Vázquez Romero, Juana María Rizo Pascual, Miguel Rivero Fernández, Rebeca Manzano Fernández, Rosario González Alonso, Eloísa Moya Valverde, Antonio Díaz Sánchez y Rocío Campos Cantero

Abstract
Background and aims: there is little scientific evidence on the outcomes of endoscopic retrograde cholangiopancreatography (ERCP) performed in low-volume hospitals; however, in our country, it is growing up its implementation. The objectives of our study were to evaluate the efficacy and safety of this technique performed by two endoscopists with basic training in a center of this nature and analyze the learning curve in the first procedures.

Patients and methods: single-center retrospective study of the first 200 ERCP performed in our hospital (analyzing the evolution between the first 100 and 100 following procedures), comparing them with the quality standards proposed in the literature.

Results: from February 2009 to April 2011, we performed 200 ERCP in 169 patients, and the most common indications were: Choledocholithiasis (77 %), tumors (14.5 %) and other conditions (8.5 %). The cannulation rate rose from 85 % in the first 100 ERCP to 89 % in the next 100 procedures, clinical success from 81 % to 87 %, decreasing the post-ERCP acute pancreatitis rate from 11 % to 4 %, upper gastrointestinal bleeding (UGIB) from 3 % to 2 % and acute cholangitis from 4 % to 1 %. There was a death from a massive UGIB in a cirrhotic patient in the first group of patients and a case of biliary perforation resolved by surgery in the second one.

Conclusions: the results obtained after performing 200 procedures support the ability to practice ERCP in low-volume hospitals obtaining levels of efficacy and safety in accordance with published quality standards.
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30/04/2013 21:41:08
Muy buen trabajo. Demuestra que un bajo volumen (relativo) pero concentrado en manos bien entrenadas proporciona alta calidad cuando se trabaja con rigor.
Enhorabuena a los autores y colaboradores del trabajo por este jalón en la literatura española sobre CPRE.
Manuel Pérez-Miranda (Valladolid)


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José María Riesco López, Manuel Vázquez Romero, Juana María Rizo Pascual, Miguel Rivero Fernández, Rebeca Manzano Fernández, Rosario González Alonso, Eloísa Moya Valverde, Antonio Díaz Sánchez y Rocío Campos Cantero. Efficacy and safety of ERCP in a low-volume hospital. 68-73-


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