Quality in ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) procedures have relatively high rates of adverse events and can be associated with a high rate of morbidity and mortality. In order to maximize success and minimize complications, multiple gastroenterology societies have emphasized training factors and metrics to maximize quality and decrease the high adverse events rate in ERCP. Prioritized measures for ERCP quality include ERCP indication, cannulation success rate, stone extraction success rate, stent placement success rate, and rate of post-ERCP pancreatitis. Other quality metrics encompass aspects of documentation and follow-up, appropriate antibiotic use, fluoroscopy duration, and adverse events. Quality metrics to mitigate post-ERCP pancreatitis include pharmacologic prophylaxis and endoscopic techniques.