Evaluation of endoscopic retrograde cholangiopancreatography procedures performed in general hospitals in France.

Objective: Evaluate endoscopic retrograde cholangiopancreatography (ERCP) in general hospitals in France.

Methods: Prospective study of ERCP procedures performed in 28 centers during an 18-month period. Success was assessed at day 1; morbidity and mortality were assessed at 30 days.

Results: 2708 ERCP procedures were performed in 28 centers. The rate of success was 92.1% and was higher among centers performing more than 200 procedures annually (OR 2.07 [1.522.86]). Therapeutic success was correlated with diameter of the common bile duct>6 mm (OR 9.1 [7.15-11.57]) and center activity level (OR 1.91 [1.38-2.6]). The rate of complications and deaths were 9.1% and 4%; procedure-specific mortality was 0.8%. Morbidity was lower in centers performing more than 200 procedures annually (OR 0.36 [0.22-0.6]) and when the operator considered the procedure easy to perform (OR 0.5 [0.35-0.74]). Mortality was correlated with ASA score (OR for patients with ASA scores 2, 3, 4 were 9 [1-66], 53.3 [7.3-392] and 164.7 [21.71249]) respectively, occurrence of a complication (OR=3.9 [1.96-7.78]), diameter of the common bile duct, and technical success (OR=0.49 [0.27-0.88]).

Conclusion: This study shows that success of ERCP and post-ERCP morbidity are related to center activity level while post-ERCP mortality is strongly linked with the patient's ASA score.