PMID- 31060119
OWN - NLM
STAT- MEDLINE
DCOM- 20210201
LR  - 20210201
IS  - 2005-1212 (Electronic)
IS  - 1976-2283 (Print)
IS  - 1976-2283 (Linking)
VI  - 14
IP  - 2
DP  - 2020 Mar 15
TI  - Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events 
      Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective 
      Observational Study.
PG  - 257-264
LID - 10.5009/gnl18537 [doi]
AB  - BACKGROUND/AIMS: Few studies have addressed the relationship between the 
      occurrence of adverse events (AEs) in endoscopic retrograde 
      cholangiopancreatography (ERCP) and hospital case volume or endoscopist's 
      experience with inconsistent results. The aim of our study was to investigate the 
      impact of hospital case volume and endoscopist's experience on the AEs associated 
      with ERCP and to analyze patient- and procedure-related risk factors for 
      post-ERCP AEs. METHODS: From January 2015 to December 2015, we prospectively 
      enrolled patients with naïve papilla who underwent ERCP at six centers. 
      Patient- and procedure-related variables were recorded on data collection sheets 
      at the time of and after ERCP. RESULTS: A total of 1,191 patients (median age, 71 
      years) were consecutively enrolled. The overall success rate of biliary 
      cannulation was 96.6%. Overall, 244 patients (20.5%) experienced post-ERCP AEs, 
      including pancreatitis (9.0%), bleeding (11.8%), perforation (0.4%), cholangitis 
      (1.2%), and others (0.9%). While post-ERCP pancreatitis (PEP) was more common 
      when the procedure was performed by less experienced endoscopists, bleeding was 
      more common in high-volume centers and by less experienced endoscopists. 
      Multivariate analysis showed that a less experience in ERCP was significantly 
      associated with PEP (odds ratio [OR], 1.630; 95% confidence interval [CI], 1.050 
      to 2.531; p=0.030) and post-ERCP bleeding (OR, 1.439; 95% CI, 1.003 to 2.062; 
      p=0.048). CONCLUSIONS: Our study demonstrated that overall AEs following ERCP 
      were associated with the experience of the endoscopist. To minimize post-ERCP 
      AEs, rigorous training with a sufficient case volume is required, and treatment 
      strategies should be modified according to the endoscopist's expertise.
FAU - Lee, Hyun Jik
AU  - Lee HJ
AUID- ORCID: 0000-0002-3929-9180
AD  - Department of Internal Medicine, Keimyung University Dongsan Medical Center, 
      Daegu, Korea.
FAU - Cho, Chang Min
AU  - Cho CM
AUID- ORCID: 0000-0002-9903-1282
AD  - Center for Pancreatobiliary Tumor, Kyungpook National University Chilgok 
      Hospital, Daegu, Korea.
AD  - Department of Internal Medicine, School of Medicine, Kyungpook National 
      University, Daegu, Korea.
FAU - Heo, Jun
AU  - Heo J
AUID- ORCID: 0000-0003-3180-1655
AD  - Department of Internal Medicine, School of Medicine, Kyungpook National 
      University, Daegu, Korea.
FAU - Jung, Min Kyu
AU  - Jung MK
AUID- ORCID: 0000-0001-8749-408X
AD  - Department of Internal Medicine, School of Medicine, Kyungpook National 
      University, Daegu, Korea.
FAU - Kim, Tae Nyeun
AU  - Kim TN
AUID- ORCID: 0000-0003-4178-2056
AD  - Department of Internal Medicine, Yeungnam University Medical Center, Daegu, 
      Korea.
FAU - Kim, Kook Hyun
AU  - Kim KH
AUID- ORCID: 0000-0001-7786-7882
AD  - Department of Internal Medicine, Yeungnam University Medical Center, Daegu, 
      Korea.
FAU - Kim, Hyunsoo
AU  - Kim H
AUID- ORCID: 0000-0001-5572-5453
AD  - Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
FAU - Cho, Kwang Bum
AU  - Cho KB
AUID- ORCID: 0000-0003-2203-102X
AD  - Department of Internal Medicine, Keimyung University Dongsan Medical Center, 
      Daegu, Korea.
FAU - Kim, Ho Gak
AU  - Kim HG
AUID- ORCID: 0000-0003-3365-1662
AD  - Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, 
      Korea.
FAU - Han, Jimin
AU  - Han J
AUID- ORCID: 0000-0001-8674-370X
AD  - Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, 
      Korea.
FAU - Lee, Dong Wook
AU  - Lee DW
AUID- ORCID: 0000-0002-1029-9064
AD  - Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, 
      Korea.
FAU - Lee, Yoon Suk
AU  - Lee YS
AUID- ORCID: 0000-0002-5835-9417
AD  - Department of Internal Medicine, Inje University College of Medicine, Busan, 
      Korea.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - Korea (South)
TA  - Gut Liver
JT  - Gut and liver
JID - 101316452
SB  - IM
MH  - Aged
MH  - Cholangiopancreatography, Endoscopic Retrograde/*statistics & numerical data
MH  - Clinical Competence/*statistics & numerical data
MH  - Female
MH  - Hospitals, High-Volume/*statistics & numerical data
MH  - Hospitals, Low-Volume/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Postoperative Complications/epidemiology/etiology
MH  - Prospective Studies
MH  - Risk Factors
MH  - Surgeons/*statistics & numerical data
MH  - Treatment Outcome
PMC - PMC7096235
OTO - NOTNLM
OT  - Adverse events
OT  - Cholangiopancreatography, endoscopic retrograde
OT  - Endoscopic experience
OT  - Hospital volume
COIS- CONFLICTS OF INTEREST No potential conflict of interest relevant to this article 
      was reported.
EDAT- 2019/05/07 06:00
MHDA- 2021/02/02 06:00
PMCR- 2020/01/07
CRDT- 2019/05/07 06:00
PHST- 2018/12/07 00:00 [received]
PHST- 2019/03/17 00:00 [revised]
PHST- 2019/03/24 00:00 [accepted]
PHST- 2019/05/07 06:00 [pubmed]
PHST- 2021/02/02 06:00 [medline]
PHST- 2019/05/07 06:00 [entrez]
PHST- 2020/01/07 00:00 [pmc-release]
AID - gnl18537 [pii]
AID - GNL-14-257 [pii]
AID - 10.5009/gnl18537 [doi]
PST - ppublish
SO  - Gut Liver. 2020 Mar 15;14(2):257-264. doi: 10.5009/gnl18537.