Influence of the Endoscopists and Endoscopic Retrograde CholangioPanceratography

Study Overview
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Brief Summary
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Retrospective analysis on a prospective database that analyzes the influence of the number of endoscopists on the Endoscopic Retrograde CholangioPanceratography result.

Detailed Description
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The number of Endoscopic Retrograde CholangioPanceratographys (ERCP) performed annually by an endoscopist has been shown to influence the outcomes of the procedure, especially on the papillary cannulation rate and the adverse effects rate. The number of ERCPs performed annually by each endoscopist is directly related to the number of endoscopists who perform this procedure, since the total number of ERCPs performed annually at each center is usually constant. The hypothesis of this study is that the number of endoscopists who perform ERCP in a hospital influences the results of the procedure, so that the fewer the number of endoscopists the better the results. To evaluate this hypothesis, the investigators have designed a retrospective study analyzing data from a prospectively filled database, which includes all ERCPs performed in our center from September 2013 to June 2020. For organizative reasons unrelated to the endoscopy unit, in the center it has beed progressively reduced the number of endoscopists who perform ERCP, starting from 5 endoscopists at the beginning of the study to 3 endoscopists at the end of the study inclusion period. In fact, three different periods of similar duration can be distinguished: September 2013 to August 2015 (5 endoscopists), September 2015 to December 2017 (4 endoscopists) and January 2018 to June 2020 (3 endoscopists). The outcomes obtained with ERCP in these three periods will be analyzed and compared, assessing the cannulation rate and the adverse effects rate as the main comparison parameters.

Official Title
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Influence of the Endoscopist Case Volumen on Endoscopic Retrograde CholangioPanceratography Outcomes

Conditions
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Biliary Disease, Pancreatic Diseases

Intervention / Treatment
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* Other: ERCP


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing ERCP with written informed consent given Staff allocated in the endoscopy unit Exclusion Criteria: Rejection to participate in the study ERCP procedures performed by fellows in training

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| September 2013 to August 2015<br>5 endoscopists | Other: ERCP<br>* ERCPs performed annually by an endoscopist<br>|
| September 2015 to December 2017<br>4 endoscopists | Other: ERCP<br>* ERCPs performed annually by an endoscopist<br>|
| January 2018 to June 2020<br>3 endoscopists | Other: ERCP<br>* ERCPs performed annually by an endoscopist<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Papillary cannulation | Rate of papillary cannulation.Success in achieving transpapillary access to the bile duct.It has to be confirmed fluoroscopically | During the procedure | 
| Adverse effects | Rate of adverse effect assessed by the ASGE classification | Up to 1 month after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Individual adverse effects | Rate of individual adverse effect during the intervention | Up to 1 month after intervention | 
| Complexity level of ERCP | Complexity level of ERCP according to ASGE classification of complexity of the endoscopic procedures | During the ERCP procedure | 
| Therapeutics performed with ERCP | Techniques used during ERCP | During the ERCP procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ERCP, endoscopy, gastrointestinal, choledocholithiasis, Endoscopic Retrograde CholangioPanceratography