Endoscopic biliopancreatic investigations and therapy.
The management of most biliopancreatic diseases benefits from endoscopic treatment. Forty years after the first endoscopic cannulation of the ampulla of Vater, the overall effectiveness and safety of endoscopic retrograde cholangiopancreatography (ERCP) can be evaluated using the quality assurance programs that have recently been developed for gastrointestinal endoscopy, including ERCP. Such evaluation does not mean simply reporting therapeutic success and complication rates; rather, it involves a complex analysis of the entire gastrointestinal unit, of the medical practises, and of patient satisfaction. The overall quality of ERCP has been analysed and many quality deficits identified, even in referral centres. Training for such a specialised procedure is difficult and expensive. Competence in ERCP requires as many as 200 ERCP procedures. Quality assurance programs can help to improve the overall quality of endoscopic practise, including training of young endoscopists.
Costamagna
Guido
G
Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore, A. Gemelli University Hospital, 8 Largo Gemelli, Rome, RM 00168, Italy. gcostamagna@rm.unicatt.it
Familiari
Pietro
P
Marchese
Michele
M
Tringali
Andrea
A
D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000592:standards; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000592:standards; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D018579:Patient Selection; D011785:Quality Assurance, Health Care / Q000592:standards; D019984:Quality Indicators, Health Care; D016896:Treatment Outcome