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Endoscopy 2008; 40(8): 625-630
DOI: 10.1055/s-2008-1077461
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Case volume and outcome of endoscopic retrograde cholangiopancreatography: results of a nationwide Austrian benchmarking project

C.  Kapral1 , C.  Duller2 , F.  Wewalka1 , E.  Kerstan3 , W.  Vogel4 , F.  Schreiber5 For the Working Groups on Quality Assurance and Endoscopy of the Austrian Society of Gastroenterology and Hepatology (OeGGH)
  • 1Department of Medicine, Konventhospital Barmherzige Brüder, Linz, Austria
  • 2Department of Applied Statistics at the Faculty of Social and Economic Sciences, Johannes Kepler University, Linz, Austria
  • 34th Medical Department, Wilhelminenspital, Vienna, Austria
  • 4Division of Gastroenterology and Hepatology, Medical University of Innsbruck, Austria
  • 5Division of Gastroenterology and Hepatology, Medical University of Graz, Austria
Further Information

Publication History

submitted 2 November 2007

accepted after revision 14 April 2008

Publication Date:
04 August 2008 (online)

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Commentaire de travail de C. Kapral et al., pp. 625Endoscopy 2008; 40(08): 796-796
DOI: 10.1055/s-0032-1306856

Background and study aim: In a quality assessment project for endoscopic retrograde cholangiopancreatography (ERCP), initiated in 2006 by the Austrian Society of Gastroenterology and Hepatology, benchmark data were collected on a voluntary basis. Results from the individual participating centers, both academic and community-based, were compared with pooled benchmark data, with the intention that individual problems should be identified and corrected in order to improve patient care in Austria. Success and complication rates in nonselected patients were evaluated, especially with regard to case volume.

Methods: In Austria, with a population of 8 million, 140 sites are registered for ERCP, and it is estimated that up to 15 000 procedures are done annually. Of these sites, 28 participated in the “Benchmarking ERCP” project during the first year, reporting on 3132 procedures, or 22 % of the total number.

Results: The overall complication rate in nonselected patients was 12.6 %, consisting of post-ERCP pancreatitis (5.1 %), bleeding (3.7 %), cholangitis (1.9 %), cardiopulmonary complications (0.9 %), and perforation (0.5 %); procedure-related mortality was 0.1 %. The overall therapeutic and diagnostic target was achieved in 84.8 %. High case volume (endoscopists performing > 50 vs. < 50 ERCPs per year; 21 vs. 68 endoscopists) was associated with significantly higher success (86.9 % vs. 80.3 %, P < 0.001) and lower overall complication rates (10.2 % vs. 13.6 %, P = 0.007); significance was not reached for all subgroups of complications.

Conclusion: Success and complication rates for ERCP in Austria are comparable to those reported elsewhere. In our study, endoscopists with a case volume exceeding 50 ERCPs per year had higher success and lower overall complication rates.

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C. Kapral, MD 

Konventhospital Barmherzige Brueder

Seilerstaette 2
4021 Linz
Austria

Fax: +43-732-789721699

Email: christine.kapral@bblinz.at