Nationwide, population-based data from 11,074 ERCP procedures from the Swedish Registry for Gallstone Surgery and ERCP.
BACKGROUND
The Swedish Registry for Gallstone Surgery and ERCP (GallRiks) is the first nationwide Web-based quality registry for gallstone surgery and ERCP in the world. In this article we report data from 11,074 ERCPs performed in 2007 and 2008.


OBJECTIVE
The aim of this study is to present outcomes, safety data, and success rates of ERCPs performed in Sweden.


METHODS
Data gathering from a medical record database.


METHODS
This study reviewed 11,074 ERCPs performed in 2007 and 2008.


METHODS
In GallRiks, data concerning surgery performed for gallstone disease as well as all ERCPs are recorded. The registry is approved by the Swedish Surgical Society and is based on an Internet platform with online data registration. The online program includes 30-day follow-up information as well as the opportunity to retrieve electronic reports on demand. The present data represent 76% of all ERCPs performed in Sweden in 2007 and 95% of those performed in 2008. The database also has been validated, indicating a complete match between the medical records and the database in 97.3% of ERCP cases.


METHODS
Cannulation success and perioperative and postoperative complications.


RESULTS
A successful bile duct cannulation was achieved in 92% of the ERCPs performed. The presence of common bile duct stones was the predominant finding and was seen in 36.8% of examinations. Perioperative and postoperative complication rates were 2.5% and 9.8%, respectively. The rate of ERCP-induced pancreatitis was 2.7%, and the total 30-day mortality rate in the database was 5.9% but varied significantly among the different diagnostic groups. The indications for ERCP differed between high-volume and low-volume centers, indicating an adequate referral pattern of complex cases in Sweden.


CONCLUSIONS
GallRiks registration is voluntary and thus not 100%. This makes selection bias a possibility.


CONCLUSIONS
ERCP is widely used at Swedish hospitals, with acceptable cannulation success rates and perioperative and postoperative complication rates similar to established standards. GallRiks is a population-based nationwide registry with good data validity and high inclusion rates regarding ERCPs.
Department of Surgical Gastroenterology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Lars
L
Enochsson
Fredrik
F
Swahn
Urban
U
Arnelo
Magnus
M
Nilsson
Matthias
M
Löhr
Gunnar
G
Persson
D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000706:statistics & numerical data*; D001651:Cholestasis, Extrahepatic / Q000453:epidemiology / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000453:epidemiology / Q000601:surgery*; D006276:Health Facility Size; D006801:Humans; D020407:Internet; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D012449:Safety; D012984:Software; D013548:Sweden; D014600:Utilization Review