Quality Indicators for Endoscopic Retrograde Cholangiopancreatography

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most technically demanding and highestrisk procedures performed by gastrointestinal endoscopists. Hence, it requires significant focused training and experience to maximize success and safety (1, 2). ERCP has evolved from a purely diagnostic to a predominately therapeutic procedure (3). ERCP and ancillary interventions are effective in the nonsurgical management of a variety of pancreaticobiliary disorders, most commonly removal of bile duct stones and relief of malignant obstructive jaundice (4). The American Society for Gastrointestinal Endoscopy (ASGE) has published specific criteria for the training and granting of clinical privileges for ERCP (5, 6) The ASGE/American College of Gastroenterology task force has established the following indicators to aid in the recognition of ERCP examinations of high quality. The levels of evidence supporting these quality indicators were graded according to Table 1. Such indicators would permit the development of quality assurance programs and enable endoscopists who perform ERCP to share their personal quality measures with patients and other interested parties.