Abstract
Background In 2018, the European Society of Gastrointestinal Endoscopy (ESGE) and United European
Gastroenterology (UEG) published quality performance measures for endoscopic retrograde
cholangiopancreatography (ERCP). Since January 2016, all endoscopists in the Netherlands
have been required to register all ERCP procedures in a nationwide quality registry.
This study aimed to evaluate the procedural success rates of ERCP after the implementation
of mandatory national registration and to compare these with the ESGE quality performance
measures.
Methods This study was conducted with data from a multicenter endoscopy database. Data from
2019 and 2020 were analyzed. The primary outcome was ERCP procedural outcome. ESGE
performance measures that could be evaluated were the percentage of successful bile
duct cannulations in patients with virgin papillary anatomy; successful stent placement
for a biliary obstruction located below the liver hilum; and complete removal of bile
duct stones (< 10 mm).
Result In total, 5295 ERCPs performed in 11 centers were included for analysis. The overall
procedural success rate was 89.1 %. Successful biliary cannulation in patients with
a virgin papilla was 90.3 % in nonacademic and 92.4 % in academic centers. The rates
of successful stent placement in patients with a biliary obstruction located below
the liver hilum were 97.0 % in nonacademic and 98.2 % in academic centers, and of
successful bile duct stone extraction were 97.9 % in both nonacademic and academic
centers.
Conclusions The quality of ERCPs performed met five of the six evaluated ESGE performance measures.
The 95 % target for successful biliary cannulation in patients with virgin papillary
anatomy in academic centers was not met. Mandatory registration provides valuable
insight into ERCP performance rates.
