title: Efficacy and safety of ERCP in a low-volume hospital.
abstract: OBJECTIVE
  there is little scientific evidence on the outcomes of endoscopic retrograde cholangiopancreatography (ERCP) performed in low-volume hospitals; however, in our country, it is growing up its implementation. The objectives of our study were to evaluate the efficacy and safety of this technique performed by two endoscopists with basic training in a center of this nature and analyze the learning curve in the first procedures.
  
  
  METHODS
  single-center retrospective study of the first 200 ERCP performed in our hospital (analyzing the evolution between the first 100 and 100 following procedures), comparing them with the quality standards proposed in the literature.
  
  
  RESULTS
  from February 2009 to April 2011, we performed 200 ERCP in 169 patients, and the most common indications were: Choledocholithiasis (77 %), tumors (14.5 %) and other conditions (8.5 %). The cannulation rate rose from 85 % in the first 100 ERCPto 89 % in the next 100 procedures, clinical success from 81 % to 87 %, decreasing the post-ERCP acute pancreatitis rate from 11 % to 4 %, upper gastrointestinal bleeding (UGIB) from 3 % to 2 % and acute cholangitis from 4 % to 1 %. There was a death from a massive UGIB in a cirrhotic patient in the first group of patients and a case of biliary perforation resolved by surgery in the second one.
  
  
  CONCLUSIONS
  the results obtained after performing 200 procedures support the ability to practice ERCP in low-volume hospitals obtaining levels of efficacy and safety in accordance with published quality standards.
authors: José María
authors: JM
authors: Riesco-López
authors: Manuel
authors: M
authors: Vázquez-Romero
authors: Juana María
authors: JM
authors: Rizo-Pascual
authors: Miguel
authors: M
authors: Rivero-Fernández
authors: Rebeca
authors: R
authors: Manzano-Fernández
authors: Rosario
authors: R
authors: González-Alonso
authors: Eloísa
authors: E
authors: Moya-Valverde
authors: Antonio
authors: A
authors: Díaz-Sánchez
authors: Rocío
authors: R
authors: Campos-Cantero
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000592:standards; D005260:Female; D061846:Hospitals, Low-Volume; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies