title: Quality assessment of endoscopic retrograde cholangiopancreatography:  results of a running nationwide Austrian benchmarking project after 5 years of implementation.
abstract: OBJECTIVE
  Endoscopic retrograde cholangiopancreatography (ERCP) has a high risk of various complications. The aim of this study is to report the main ERCP outcome, that means complications and success rates, on the basis of the pooled data of a national continuous quality assessment program.
  
  
  METHODS
  This study is an uncontrolled prospective survey and provides data from both academic and community-based endoscopy centers with varying case volumes and expertise. Data were collected within a nationwide voluntary ERCP benchmarking project that was initiated by the Austrian Society of Gastroenterology and Hepatology.
  
  
  RESULTS
  In total, 42 sites participated in this program for varying periods (1 month up to 5 years) and reported 13 513 procedures within 5 years. The overall complication rate in nonselected patients was 10.1%. Post-ERCP pancreatitis occurred in 4.2%, bleeding in 3.6% (0.4% clinically relevant), cholangitis in 1.4%, cardiopulmonary complications in 1.2%, perforation in 0.6%, and procedure-related deaths in 0.1% of procedures. The overall therapeutic and diagnostic target was achieved in 80.3% (2009-2011) to 84.8% (2006/2007) of procedures. The desired duct was visualized in 90.7% and cannulated in 88.8% of procedures.
  
  
  CONCLUSIONS
  The aim of the running benchmarking project in ERCP is to improve patient care in Austria. The survey reflects the general effectiveness and safety of ERCP. The overall complication and success rates are consistent with the available literature data. It sets an example as a benchmarking program that might result in international or even pan-European projects in high-risk endoscopic procedures.
authors.affiliation: 4th Medical Department, Elisabethinen Hospital, Linz, Austria. christine.kapral@elisabethinen.or.at
authors.forename: Christine
authors.initials: C
authors.lastname: Kapral
authors.forename: Andrea
authors.initials: A
authors.lastname: Mühlberger
authors.forename: Friedrich
authors.initials: F
authors.lastname: Wewalka
authors.forename: Christine
authors.initials: C
authors.lastname: Duller
authors.forename: Peter
authors.initials: P
authors.lastname: Knoflach
authors.forename: Florian
authors.initials: F
authors.lastname: Schreiber
mesh_terms: D000046:Academic Medical Centers / Q000592:standards; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D019985:Benchmarking / Q000592:standards*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D003153:Community Health Services / Q000592:standards; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D011183:Postoperative Complications / Q000453:epidemiology; D015397:Program Evaluation; D011446:Prospective Studies; D058996:Quality Improvement / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult