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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(10): E1563-E1571
DOI: 10.1055/a-1531-4691
Original article

A prospective study on quality in endoscopic retrograde cholangiopancreatography (ERCP): trend in Italy from the REQUEST study

Giulio Donato
 1   Gastroenterology Unit, Department of Oncological and Specialty Medicine, Ospedale “Maggiore della Carità”, Novara, Italy
,
Pietro Occhipinti
 1   Gastroenterology Unit, Department of Oncological and Specialty Medicine, Ospedale “Maggiore della Carità”, Novara, Italy
,
Loredana Correale
 1   Gastroenterology Unit, Department of Oncological and Specialty Medicine, Ospedale “Maggiore della Carità”, Novara, Italy
,
Marco Spadaccini
 2   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
 3   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy; Department of Biomedical Sciences, Pieve Emanuele, Milano, Italy
,
Alessandro Repici
 2   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
 3   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy; Department of Biomedical Sciences, Pieve Emanuele, Milano, Italy
,
Andrea Anderloni
 2   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
,
Alessandro Fugazza
 2   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
,
Piergiorgio Mosca
 4   Division of Gastroenterology, Department of Gastroenterology & Transplantation, AOU Ospedali Riuniti, Ancona, Italy
,
Andrea Tringali
 5   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
 6   Centre for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, Roma, Italy
,
Guido Costamagna
 5   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
 6   Centre for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, Roma, Italy
,
Milutin Bulajic
 7   Gastroenterology and GI Endoscopy Unit, University Hospital of Udine, Udine, Italy
 8   Mater Olbia Hospital-Qatar Foundation Endowment & Gemelli Foundation, Gastroenterology and GI Endoscopy Unit, Olbia (OT), Italy
,
Giovanni de Pretis
 9   Gastroenterology and Digestive Endoscopy Unit, Ospedale S. Chiara, Trento, Italy
,
Armando Gabbrielli
10   Digestive Endoscopy Unit, AOUI Verona, Italy
,
Francesco Maria Di Matteo
11   Operative Digestive Endoscopy Unit, Policlinico Universitario Campus Bio-Medico di Roma, Roma
,
Roberto Faggiani
12   Gastroenterology and Endoscopy Unit, Department of Oncological and Specialty Medicine, S. Camillo Forlanini Hospital, Rome, Italy
,
Mohammad Ayoubi
13   Gastroenterology and Endoscopy Unit, Gradenigo-Humanitas, Torino, Italy
,
Luca De Luca
14   Gastroenterology and Digestive Endoscopy Unit, A.O. Ospedale Riuniti Marche Nord, Pesaro, Italy
,
Paolo Cantù
15   Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
,
Matteo Blois
16   Interventional Endoscopy Unit, Azienda USL Toscana Nord-Ovest, Livorno, Italy
,
Iginio Dell’Amico
17   Endoscopy Unit, Apuane Hospital, Massa-Carrara, Italy
,
Attilio Maurano
18   Operative Endoscopy Unit, Azienda Ospedaliera Universitaria di Salerno, Italy
,
Maria Flavia Savarese
19   Gastroenterology and Gastrointestinal Endoscopy, General Hospital, Sanremo (IM), Italy
,
Giampiero Manes
20   Department of Gastroenterology and Digestive Endoscopy, ASST Rhodense Garbagnate Milanese, Milano, Italy
,
Raffaella Ferraro
21   Gastroenterology and Digestive Endoscopy Unit, Ospedale S. Andrea, ASL VC, Vercelli, Italy
,
Mauro Barberis
22   Gastroenterology Unit, Policlinico di Monza, Monza (MB), Italy
,
Cesare Hassan
23   Department of Gastroenterology, Nuovo Regina Margherita Hospital, Roma, Italy
,
The REQUEST Group › Author Affiliations
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Abstract

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure with a relatively high rate of adverse events. Data on training of operators and fulfillment of quality indicators in Italy are scarce. The goal of this study was to assess the overall quality of ERCP in Italy compared to international standards.

Patients and methods This was a prospective, observational study from different Italian centers performing ERCP. Operators answered a questionnaire, then recorded data on ERCPs over a 1-to 3-month period.

Results Nineteen Italian centers participated in the study. The most common concern of operators about training was the lack of structured programs. Seven/19 centers routinely used conscious sedation for ERCP. Forty-one experienced operators and 21 trainees performed 766 ERCPs: a successful deep biliary cannulation in native-papilla patients was achieved in 95.1 % of cases; the post-ERCP pancreatitis (PEP) rate was 5.4 % in native-papilla patients; cholangitis rate was 1.0 %; bleeding and perforation occurred in 2.7 % and 0.4 % of the patients, respectively.

Conclusions This study revealed that, overall, ERCP is performed in the participating Italian centers meeting good quality standards, but structured training and sedation practice are still subpar. The bleeding and perforation rate slightly exceeded the American Society of Gastrointestinal Endoscopy indicator targets but they are comparable to the reported rates from other international surveys.

Supplementary material



Publication History

Received: 18 March 2021

Accepted: 07 June 2021

Article published online:
16 September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
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