ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat procedures
Background and study aims Bile duct stones (BDS) represent approximately 50 % of the requirement for endoscopic retrograde cholangiopancreatography (ERCP) within most services. Significant variation in outcome rates for BDS clearance at ERCP has been reported, and endoscopy societies have set standa...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2023-02-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1951-4421 |
| _version_ | 1811173029142593536 |
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| author | Harry Martin Richard Sturgess Neil Mason Adam Ceney Jodi Carter Lilith Barca James Holland Simon Swift George J. Webster |
| author_facet | Harry Martin Richard Sturgess Neil Mason Adam Ceney Jodi Carter Lilith Barca James Holland Simon Swift George J. Webster |
| author_sort | Harry Martin |
| collection | DOAJ |
| description | Background and study aims Bile duct stones (BDS) represent approximately 50 % of the requirement for endoscopic retrograde cholangiopancreatography (ERCP) within most services. Significant variation in outcome rates for BDS clearance at ERCP has been reported, and endoscopy societies have set standards for expected clearance rates. The aim of this study was to analyze procedure outcomes across a national service.
Patients and methods Using verified hospital episode statistics (HES) data for the National Health Service (NHS) in England, we analyzed all patients having first ERCPs for BDS from 2015 to 2017, and followed these patients for at least 2 years.
Results In total 37,468 patients underwent a first ERCP for BDS, with 69.8 % undergoing only one procedure. This figure of less than 70 % of BDS cleared at first ERCP is below the Key Performance Indicators as set by the British Society of Gastroenterology (> 75 %) and the European Society of Gastrointestinal Endoscopy (> 90 %). Of 55,556 ERCPs done for BDS, 52.9 % were repeat procedures, with 11,322 patients needing multiple procedures. For hospitals performing significant numbers of ERCPs (more than 600 for BDS during the study period) patients undergoing repeat ERCPs for BDS ranged from 9 % to 50 %.
Conclusions In this nationwide study, the performance at clearing BDS at first ERCP was suboptimal, with high numbers of repeat procedures required. This may have a negative impact on both patient outcomes and experience, and increase pressure on endoscopy services. Apparent variation of outcome between acute hospital care providers requires further analysis. |
| first_indexed | 2024-04-10T17:41:17Z |
| format | Article |
| id | doaj.art-9995677d78f1488b80a77329644b246a |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-10T17:41:17Z |
| publishDate | 2023-02-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-9995677d78f1488b80a77329644b246a2023-02-03T13:43:22ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362023-02-011102E142E14810.1055/a-1951-4421ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat proceduresHarry Martin0Richard Sturgess1Neil Mason2Adam Ceney3Jodi Carter4Lilith Barca5James Holland6Simon Swift7George J. Webster8Pancreatobiliary Medicine, University College London Hospitals, London, UKDepartment of Gastroenterology Liverpool University NHS trustMethods Analytics, London, UKMethods Analytics, London, UKMethods Analytics, London, UKMethods Analytics, London, UKMethods Analytics, London, UKMethods Analytics, London, UKPancreatobiliary Medicine, University College London Hospitals, London, UKBackground and study aims Bile duct stones (BDS) represent approximately 50 % of the requirement for endoscopic retrograde cholangiopancreatography (ERCP) within most services. Significant variation in outcome rates for BDS clearance at ERCP has been reported, and endoscopy societies have set standards for expected clearance rates. The aim of this study was to analyze procedure outcomes across a national service. Patients and methods Using verified hospital episode statistics (HES) data for the National Health Service (NHS) in England, we analyzed all patients having first ERCPs for BDS from 2015 to 2017, and followed these patients for at least 2 years. Results In total 37,468 patients underwent a first ERCP for BDS, with 69.8 % undergoing only one procedure. This figure of less than 70 % of BDS cleared at first ERCP is below the Key Performance Indicators as set by the British Society of Gastroenterology (> 75 %) and the European Society of Gastrointestinal Endoscopy (> 90 %). Of 55,556 ERCPs done for BDS, 52.9 % were repeat procedures, with 11,322 patients needing multiple procedures. For hospitals performing significant numbers of ERCPs (more than 600 for BDS during the study period) patients undergoing repeat ERCPs for BDS ranged from 9 % to 50 %. Conclusions In this nationwide study, the performance at clearing BDS at first ERCP was suboptimal, with high numbers of repeat procedures required. This may have a negative impact on both patient outcomes and experience, and increase pressure on endoscopy services. Apparent variation of outcome between acute hospital care providers requires further analysis.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1951-4421 |
| spellingShingle | Harry Martin Richard Sturgess Neil Mason Adam Ceney Jodi Carter Lilith Barca James Holland Simon Swift George J. Webster ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat procedures Endoscopy International Open |
| title | ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat procedures |
| title_full | ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat procedures |
| title_fullStr | ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat procedures |
| title_full_unstemmed | ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat procedures |
| title_short | ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat procedures |
| title_sort | ercp for bile duct stones across a national service demonstrating a high requirement for repeat procedures |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1951-4421 |
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