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ERCP (endoscopic retrograde cholangiopancreatography) is a procedure used to diagnose and treat diseases of the gallbladder, bile system, pancreas, and liver.

ERCP Cannulation Rate

What are we measuring?

The percentage of ERCPs at which the physician was able to successfully insert a catheter into the bile duct and / or the pancreas duct. Access to these ducts is one of the most important steps in ERCP. Without access to these ducts, other treatments like removing stones or inserting stents cannot be performed. At BIDMC, we track cannulation rates for all ERCPs performed

Why is this important?

A successful cannulation in an ERCP ensures a proper visual image of the biliary structures and improves the accuracy of diagnosis, and treatment. It can reduce the need for more invasive follow-up procedures such as surgery. Medical studies have shown that ERCP success rates at or above 90% are achieved by experienced providers.

What is BIDMC's performance?

Source of performance data is BIDMC Administrative Databases
Source of benchmark data: Baron et al. Quality indicators for endoscopic retrograde cholangiopancreatography. Am J Gastroenterology (2006) vol. 101 (4) pp. 892-7

What are we doing to improve?

As part of our preparation and planning for each patient's ERCP procedure, our endoscopists make special notations within the patients medical and scheduling records about any special issues and needs, so that this information is available to our scheduling team when scheduling each patient's procedure. Additionally, we have reviewed our written patient preparation materials and guidelines to ensure we provide clear guidance to our patients and referring physicians.

To support patients and families while awaiting for and during procedures, we practice "20-minute Rounding."  Every 20 minutes, a member of our team will "check-in" with awaiting family members to address any needs or concerns, and answer any questions.

ERCP Complication Rate

What are we measuring?

The overall complication rate for ERCPs performed at BIDMC. Serious complications include inflammation of the pancreas (pancreatitis), bowel perforation, and bleeding. Complications requiring hospitalization may occur; however, they are uncommon.

Why is this important?

With any procedure, one of the biggest concerns is post-procedure complications. Serious complications such as perforations, bleeding or pancreatitis may require immediate medical interventions, transfusions, and/or hospitalization.

What is BIDMC's performance?  

Source of Performance data is BIDMC Administrative Database
Source of Benchmark: Kapral C, et al, Case volume and outcome of endocopic retrogade cholangiopancreatography: results of a nationwide austrian benchmarking project, Endoscopy, August 2008.

What are we doing to improve?

Patient involvement and education is a key element of patient safety. At BIDMC, all patients undergoing colonoscopies are provided with information about their procedure prior to their appointment to ensure that they can properly prepare.
At the time of each patient's procedure, BIDMC has implemented a series of steps and activities designed to ensure patient safety, including:

  • Pre-procedure "Universal Time Out" involving all procedure team members to verify correct patient, correct procedure, correct position. 
  • An additional "Safety Time Out" to involving all procedure team members to verify the location and usage of the safety mechanisms for medical equipment and tables used. 
  • Verbal "read back" verification between the endoscopist and nursing team members of equipment settings used during the procedure as appropriate 
  • Careful monitoring of patients during the procedure and immediately afterward during post recovery. Most patients undergo moderate sedation for the procedure, so to ensure patient safety and comfort all patients are monitored closely during their procedure as well as post procedure recovery, and anesthesiologists are available if needed. 
  • To ensure the safety and comfort, specialized tables and equipment are provided for patients with specific medical needs.

Additionally, BIDMC's routinely monitors its performance, using a broad list of quality and safety performance measures (including the measures presented here) to ensure compliance with recommended guidelines and nationally recognized benchmarks. This data is reviewed quarterly by the Division leadership for quality and safety.

Learn about Patient Satisfaction with GI Care
Learn about Colonoscopy Care

Last Updated October 6, 2011

Contact Information

Silverman Institute for Health Care Quality and Safety
Beth Israel Deaconess Medical Center
330 Brookline Ave
Boston, MA 02215