Quality indicators for endoscopic retrograde cholangiopancreatography

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most technically demanding and highest-risk procedures performed by gastrointestinal endoscopists. Hence, it requires significant focused training and experience to maximize success and safety. 1 Sivak Jr., M.V. Trained in ERCP. Gastrointest Endosc. 2003; 58: 412-414 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar , 2 Jowell P.S. Baillie J. Branch M.S. et al. Quantitative assessment of procedural competence: a prospective study of training in endoscopic retrograde cholangiopancreatography. Ann Intern Med. 1996; 125: 983-989 Crossref PubMed Scopus (238) Google Scholar ERCP has evolved from a purely diagnostic to a predominately therapeutic procedure. 3 Carr-Locke D.L. Overview of the role of ERCP in the management of diseases of the biliary tract and the pancreas. Gastrointest Endosc. 2002; 56: S157-S160 Abstract Full Text Full Text PDF PubMed Google Scholar ERCP and ancillary interventions are effective in the nonsurgical management of a variety of pancreaticobiliary disorders, most commonly removal of bile duct stones and relief of malignant obstructive jaundice. 4 Hawes R.H. Diagnostic and therapeutic uses of ERCP in pancreatic and biliary tract malignancies. Gastrointest Endosc. 2002; 56: S201-S205 Abstract Full Text Full Text PDF PubMed Google Scholar The American Society for Gastrointestinal Endoscopy (ASGE) has published specific criteria for the training and granting of clinical privileges for ERCP. 5 Van Dam J. Brady P.G. Freeman M. et al. Guidelines for training in endoscopic ultrasound. Gastrointest Endosc. 1999; 49: 829-833 Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar , 6 Eisen G.M. Hawes R.H. Dominitz J.A. et al. Guidelines for credentialing and granting privileges for endoscopic ultrasound. Gastrointest Endosc. 2002; 54: 811-814 Abstract Full Text Full Text PDF Scopus (186) Google Scholar The ASGE/American College of Gastroenterology task force has established the following indicators to aid in the recognition of ERCP examinations of high quality. The levels of evidence supporting these quality indicators were graded according to Table 1. Such indicators would permit the development of quality assurance programs and enable endoscopists who perform ERCP to share their personal quality measures with patients and other interested parties.