BACKGROUND: The utility of the American Society for Gastrointestinal Endoscopy (ASGE) grading scale assessing complexity of endoscopic retrograde cholangiopancreatography (ERCP) has not been evaluated in clinical practice. METHODS: Patients that underwent ERCP between January 2015 and December 2015 were included. Procedural difficulty was graded according to the grading system proposed by the ASGE workshop. Technical success rates and complications were recorded. RESULTS: A total of 1355 ERCPs were performed on 934 patients. Patients were equally divided with respect to gender and had a mean age of 58 years (range 29-86). 391 cases were grade 1, 2 (29%), 695 were grade 3 (51%), and 269 were grade 4 (20%). Altered anatomy was observed in 88% of grade 4 patients. Cannulation was achieved in 98% of cases graded 1-3 and in 88% of cases graded 4 (p < 0.05). Complications were recorded in 10% of all cases with post-ERCP pancreatitis (5.4%) and procedure-related bleeding (1.5%) being the more common ones. No statistically significant difference was noted between the groups with regard to complications. Three perforations were seen in grade 1-3 cases (0.3%) compared to 4 cases in grade 4 cases (1.5%), (p = 0.01). CONCLUSION: The grading system proposed by the ASGE workshop can aid in predicting cannulation success and perforation rates in ERCP. Based on this retrospective study, the most complex ERCP procedures can be achieved with encouraging rates of success. There is a need to validate our study with prospective ones performed in other high-volume centers.
BACKGROUND: The utility of the American Society for Gastrointestinal Endoscopy (ASGE) grading scale assessing complexity of endoscopic retrograde cholangiopancreatography (ERCP) has not been evaluated in clinical practice. METHODS:Patients that underwent ERCP between January 2015 and December 2015 were included. Procedural difficulty was graded according to the grading system proposed by the ASGE workshop. Technical success rates and complications were recorded. RESULTS: A total of 1355 ERCPs were performed on 934 patients. Patients were equally divided with respect to gender and had a mean age of 58 years (range 29-86). 391 cases were grade 1, 2 (29%), 695 were grade 3 (51%), and 269 were grade 4 (20%). Altered anatomy was observed in 88% of grade 4 patients. Cannulation was achieved in 98% of cases graded 1-3 and in 88% of cases graded 4 (p < 0.05). Complications were recorded in 10% of all cases with post-ERCP pancreatitis (5.4%) and procedure-related bleeding (1.5%) being the more common ones. No statistically significant difference was noted between the groups with regard to complications. Three perforations were seen in grade 1-3 cases (0.3%) compared to 4 cases in grade 4 cases (1.5%), (p = 0.01). CONCLUSION: The grading system proposed by the ASGE workshop can aid in predicting cannulation success and perforation rates in ERCP. Based on this retrospective study, the most complex ERCP procedures can be achieved with encouraging rates of success. There is a need to validate our study with prospective ones performed in other high-volume centers.
Authors: Michelle A Anderson; Laurel Fisher; Rajeev Jain; John A Evans; Vasundhara Appalaneni; Tamir Ben-Menachem; Brooks D Cash; G Anton Decker; Dayna S Early; Robert D Fanelli; Deborah A Fisher; Norio Fukami; Joo Ha Hwang; Steven O Ikenberry; Terry L Jue; Khalid M Khan; Mary Lee Krinsky; Phyllis M Malpas; John T Maple; Ravi N Sharaf; Amandeep K Shergill; Jason A Dominitz Journal: Gastrointest Endosc Date: 2012-03 Impact factor: 9.427
Authors: Peter B Cotton; Glenn M Eisen; Lars Aabakken; Todd H Baron; Matt M Hutter; Brian C Jacobson; Klaus Mergener; Albert Nemcek; Bret T Petersen; John L Petrini; Irving M Pike; Linda Rabeneck; Joseph Romagnuolo; John J Vargo Journal: Gastrointest Endosc Date: 2010-03 Impact factor: 9.427
Authors: Peter B Cotton; Glenn Eisen; Joseph Romagnuolo; John Vargo; Todd Baron; Paul Tarnasky; Steve Schutz; Brian Jacobson; Chris Bott; Bret Petersen Journal: Gastrointest Endosc Date: 2011-03-05 Impact factor: 9.427
Authors: Vinay Chandrasekhara; Mouen A Khashab; V Raman Muthusamy; Ruben D Acosta; Deepak Agrawal; David H Bruining; Mohamad A Eloubeidi; Robert D Fanelli; Ashley L Faulx; Suryakanth R Gurudu; Shivangi Kothari; Jenifer R Lightdale; Bashar J Qumseya; Aasma Shaukat; Amy Wang; Sachin B Wani; Julie Yang; John M DeWitt Journal: Gastrointest Endosc Date: 2016-08-18 Impact factor: 9.427
Authors: Vivian E Ekkelenkamp; Robert A de Man; Frank Ter Borg; Pieter C J Ter Borg; Marco J Bruno; Marcel J M Groenen; Bettina E Hansen; Antonie J P van Tilburg; Erik A J Rauws; Arjun D Koch Journal: Endoscopy Date: 2015-01-15 Impact factor: 10.093
Authors: Gregory A Coté; B Joseph Elmunzer; Erin Forster; Robert A Moran; John G Quiles; Daniel S Strand; Dushant S Uppal; Andrew Y Wang; Peter B Cotton; Michael G McMurtry; James M Scheiman Journal: Tech Innov Gastrointest Endosc Date: 2021-01-18