Post-ERCP Acute Pancreatitis
Conditions
Keywords
performance measures, ESGE, post-ERCP pancreatitis, quality in endoscopy
Brief summary
The primary aim of the present study is to compare the incidence of post-ERCP pancreatitis (PEP) before and after the implementation of the QIC-guideline in 2017: Performance measures for ERCP and endoscopic ultrasound: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative.
Detailed description
In 2017, a new guideline addressing the quality in ERCP entitled Performance measures for ERCP and endoscopic ultrasound: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative was published. The focus of the quality improvement committee (QIC) of the ESGE is to ensure high standard of all endoscopy examinations throughout Europe by adhering to quality-improving factors (key performance indicators and minor performance indicators as defined by the ESGE). The study shall provide the investigators with information whether the introduction of the quality performance measures adopted by the European Society of Endoscopy (ESGE) will actually lead to an improvement in quality. The study will compare the quality development in endoscopy based on following time intervals: 1. before introduction of the QIC-initiative (before 2017) 2. after the introduction of the initiative (2017-2023) (both retrospective data), 3. prospectively, from 2024 onwards. The primary endpoint of this study will be the key performance indicator post-ERCP pancreatitis (PEP). In the ESGE-guideline, a minimum standard of \<10% and a target standard of \<5% was recommended. Different studies described the incidence of post-ERCP pancreatitis between 3,47% and 10,2%. The investigators hope that this study will lead to even greater patient safety in the future by improving findings and examination quality and therefore reduce the incidence of post-ERCP pancreatitis. In addition, the aim is to harmonize the high endoscopic standards throughout Europe.
Interventions
None listed
Sponsors
University of Kiel
University of Copenhagen
Johannes Gutenberg University Mainz
University Hospital Muenster
Universität Münster
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
nclusion criteria Individuals eligible for inclusion are patients referred for ERCP who do not fulfill one of the following
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post-ERCP pancreatitis (PEP) | 2016 - 2025 | Comparison of the incidence of PEP before and after the implementation of the guideline. i. Clinical illness with typical pain (physical examination: pain in the upper belly with/without radiation to the back, tenderness when touching the belly) ii. laboratory testing with 3x increase of lipase (or amylase) iii. Characteristic findings in CE-CT, MRI or transabdominal sonography iv. Requiring extension of hospital stay |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bile duct stone extraction | 2016 - 2025 | Rate of successful bile duct stone extraction |
| Adequate antibiotic prophylaxis before ERCP | 2016 - 2025 | Rate of adequate antibiotic prophylaxis before ERCP |
| Bile duct cannulation | 2016 - 2025 | Rate of successful bile duct cannulation |
| Appropriate stent placement in patients with biliary obstruction below the hilum | 2016 - 2025 | Rate of appropriate stent placement in patients with biliary obstruction below the hilum |
Countries
Germany
Outcome results
None listed