title: The impact of post-procedure interpretation of ERCP X-ray films by radiologists on patient care: should it be routine or selective?
abstract: BACKGROUND
  Review of ERCP x-ray films by radiologists is routine, but the utility of this practice is unproven. The aim of this study was to assess whether the routine post-procedural interpretation of ERCP films by radiologists alters patient management.
  
  
  METHODS
  A retrospective analysis of 212 ERCPs followed by a prospective analysis of 112 ERCPs was performed. Comparative ductogram interpretations were categorized as: I, complete agreement; II, minor findings reported only by the radiologist; III, findings reported only by the endoscopist; and IV, major findings reported only by the radiologist that altered or should have altered management.
  
  
  RESULTS
  In the retrospective analysis, 289 ductograms were identified, and interpretations were classified as: category I, 73%; category II, 16%; category III, 10.7%; and category IV, 0.3%. In the prospective study, interpretations of 167 ductograms were analyzed and classified as follows: category I, 84%; category II, 11%; category III, 5%; category IV, none.
  
  
  CONCLUSIONS
  Post-procedure interpretation of ERCP spot x-ray films by radiologists adds little to patient management. Selective consultation with radiologists would appear to be more appropriate than review by radiologists of ERCP spot x-ray films on a routine basis.
authors.affiliation: Disease Center, Division of Digestive Diseases, University of Cincinnati, 231 Albert B. Sabin Way, P.O. Box 670595, Cincinnati, OH 45267-0595, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Sweeney
authors.forename: Raj J
authors.initials: RJ
authors.lastname: Shah
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Martin
authors.forename: Charles D
authors.initials: CD
authors.lastname: Ulrich
authors.forename: Lehel
authors.initials: L
authors.lastname: Somogyi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation; D012189:Retrospective Studies