Published online Nov 16, 2023. doi: 10.4253/wjge.v15.i11.641
Peer-review started: April 28, 2023
First decision: July 4, 2023
Revised: August 6, 2023
Accepted: September 27, 2023
Article in press: September 27, 2023
Published online: November 16, 2023
Processing time: 195 Days and 23.8 Hours
Perforations (Perf) during endoscopic retrograde cholangiopancreatography (ERCP) are rare (< 1%) but potentially fatal events (up to 20% mortality). Given its rarity, most data is through case series studies from centers or analysis of large databases. Although a meta-analysis has shown fewer adverse events as a composite (bleeding, pancreatitis, Perf) during ERCP performed at high-volume centers, there is very little real-world data on endoscopist and center procedural volumes, ERCP duration and complexity on the occurrence of Perf.
To study the profile of Perf related to ERCP by center and endoscopist procedure volume, ERCP time, and complexity from a national endoscopic repository.
Patients from clinical outcomes research initiative-national endoscopic database (2000-2012) who underwent ERCP were stratified based on the endoscopist and center volume (quartiles), and total procedure duration and complexity grade of the ERCP based on procedure details. The effects of these variables on the Perf that occurred were studied. Continuous variables were compared between Perf and no perforations (NoPerf) using the Mann-Whitney U test as the data demonstrated significant skewness and kurtosis.
A total of 14153 ERCPs were performed by 258 endoscopists, with 20 reported Perf (0.14%) among 16 endoscopists. Mean patient age in years 61.6 ± 14.8 vs 58.1 ± 18.8 (Perf vs. NoPerf, P = NS). The cannulation rate was 100% and 91.5% for Perf and NoPerf groups, respectively. 13/20 (65%) of endoscopists were high-volume performers in the 4th quartile, and 11/20 (55%) of Perf occurred in centers with the highest volumes (4th quartile). Total procedure duration in minutes was 60.1 ± 29.9 vs 40.33 ± 23.5 (Perf vs NoPerf, P < 0.001). Fluoroscopy duration in minutes was 3.3 ± 2.3 vs 3.3 ± 2.6 (Perf vs NoPerf P = NS). 50% of the procedures were complex and greater than grade 1 difficulty. 3/20 (15%) patients had prior biliary surgery. 13/20 (65%) had sphincterotomies performed with stent insertion. Peritonitis occurred in only 1/20 (0.5%).
Overall adverse events as a composite during ERCP are known to occur at a lower rate with higher volume endoscopists and centers. However, Perf studied from the national database show prolonged and more complex procedures performed by high-volume endoscopists at high-volume centers contribute to Perf.
Core Tip: We analyzed the profile of perforations (Perf) related to endoscopic retrograde cholangiopancreatography (ERCP) from the clinical outcomes research initiative-national endoscopic database over 12 years. The retrospective analysis of 14153 ERCPs done by 258 endoscopists reported a Perf rate of 0.14% (20 Perf) among 16 endoscopists. The cannulation rate was 100% for Perf and 91.5% for no Perf groups. 65% of endoscopists were high-volume performers, and 55% of Perf occurred in centers with the highest volumes (4th quartile). Higher volume endoscopists and centres are known to have less ERCP-related adverse events. However, this national database study on Perf has shown prolonged and complex procedures performed by high-volume endoscopists at high-volume centers contributed to Perf.