The impact of post-procedure interpretation of ERCP X-ray films by radiologists on patient care: should it be routine or selective?
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.
Sweeney
John T
JT
Disease Center, Division of Digestive Diseases, University of Cincinnati, 231 Albert B. Sabin Way, P.O. Box 670595, Cincinnati, OH 45267-0595, USA.
Shah
Raj J
RJ
Martin
Stephen P
SP
Ulrich
Charles D
CD
Somogyi
Lehel
L
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