title: Multidisciplinary team meeting before therapeutic ERCP: A prospective study with 1,909 cases.
abstract: OBJECTIVE
  To determine the effect of multidisciplinary team meeting (MDTM) on the success rate and complications of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for hepato-pancreato-biliary diseases.
  
  
  METHODS
  All patients undergoing their first therapeutic ERCP over a 21-month period of time in a tertiary care medical center were included. Generally, patients scheduled for ERCP on Friday, Saturday, Sunday, and Monday were subject to MDTM group, and those on Tuesday, Wednesday, and Thursday were allocated to the control group. For each MDTM case, an MDTM was held on the Tuesday prior to the scheduled ERCP. At the meeting, the cases were discussed by a team consisting of chief physicians, radiologists, endoscopists, anesthetists, and surgeons, and a decision was made on the schedule of ERCP. For control cases, a clinical team of one chief physician and two attending physicians made the decision.
  
  
  RESULTS
  From April 2006 to December 2007, 912 and 997 ERCP procedures were allocated to the MDTM and control groups, respectively. There was no significant difference in the baseline characteristics and indications between the two groups. Although the success rates were not significantly different between MDTM and control groups (82.9% vs. 84.8%, P=0.321), MDTM was significantly associated with a decreased overall complication rate of (6.9% vs. 12.0%, p<0.001) and severe complication rate (0.4% vs. 2.5%, p=0.035).
  
  
  CONCLUSIONS
  Pre-ERCP MDTM decreases the frequency and severity of ERCP-related complications, with similar success rate, compared to routine practice.
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Zhuan
authors.initials: Z
authors.lastname: Liao
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Liang-Hao
authors.initials: LH
authors.lastname: Hu
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Zhao-Shen
authors.initials: ZS
authors.lastname: Li
authors.affiliation: Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Chang-Jing
authors.initials: CJ
authors.lastname: Zuo
authors.affiliation: Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Jin
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Duo-Wu
authors.initials: DW
authors.lastname: Zou
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Zhen-Dong
authors.initials: ZD
authors.lastname: Jin
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Shu-De
authors.initials: SD
authors.lastname: Li
authors.affiliation: Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Anesthetists, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Xian-Bao
authors.initials: XB
authors.lastname: Zhan
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Yuan
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Luo-Wei
authors.initials: LW
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang