Elsevier

Gastrointestinal Endoscopy

Volume 72, Issue 6, December 2010, Pages 1175-1184.e3
Gastrointestinal Endoscopy

Original Article: Clinical Endoscopy
Nationwide, population-based data from 11,074 ERCP procedures from the Swedish Registry for Gallstone Surgery and ERCP

https://doi.org/10.1016/j.gie.2010.07.047Get rights and content

Background

The Swedish Registry for Gallstone Surgery and ERCP (GallRiks) is the first nationwide Web-based quality registry for gallstone surgery and ERCP in the world. In this article we report data from 11,074 ERCPs performed in 2007 and 2008.

Objective

The aim of this study is to present outcomes, safety data, and success rates of ERCPs performed in Sweden.

Design

Data gathering from a medical record database.

Patients

This study reviewed 11,074 ERCPs performed in 2007 and 2008.

Methods

In GallRiks, data concerning surgery performed for gallstone disease as well as all ERCPs are recorded. The registry is approved by the Swedish Surgical Society and is based on an Internet platform with online data registration. The online program includes 30-day follow-up information as well as the opportunity to retrieve electronic reports on demand. The present data represent 76% of all ERCPs performed in Sweden in 2007 and 95% of those performed in 2008. The database also has been validated, indicating a complete match between the medical records and the database in 97.3% of ERCP cases.

Main Outcome Measurements

Cannulation success and perioperative and postoperative complications.

Results

A successful bile duct cannulation was achieved in 92% of the ERCPs performed. The presence of common bile duct stones was the predominant finding and was seen in 36.8% of examinations. Perioperative and postoperative complication rates were 2.5% and 9.8%, respectively. The rate of ERCP-induced pancreatitis was 2.7%, and the total 30-day mortality rate in the database was 5.9% but varied significantly among the different diagnostic groups. The indications for ERCP differed between high-volume and low-volume centers, indicating an adequate referral pattern of complex cases in Sweden.

Limitations

GallRiks registration is voluntary and thus not 100%. This makes selection bias a possibility.

Conclusion

ERCP is widely used at Swedish hospitals, with acceptable cannulation success rates and perioperative and postoperative complication rates similar to established standards. GallRiks is a population-based nationwide registry with good data validity and high inclusion rates regarding ERCPs.

Section snippets

GallRiks

The registry has from the start been financially supported by the Swedish National Board of Health and Welfare. The registry includes data for both open and laparoscopic surgery of the gallbladder (gallstone indication) as well as all ERCPs, with the aim of obtaining a complete registration of interventional gallstone treatment and its complication rates. The registry is approved by the Swedish Surgical Society, which also appoints the members of the GallRiks board. GallRiks uses an Internet

Characterization of the population under study

The majority of patients (7256, 66%) had an emergency/urgent indication for ERCP, whereas 3816 (34%) of the examinations were scheduled elective procedures (in 2 cases, data were missing). Of all ERCPs, 1477 (13%) were performed on an outpatient basis. There was a predominance of women (55%) over men. The overall mean age was 67.6 years. There was a wide variation between the number of ERCPs per patient (1-11) during the study period (Table 1).

The total number of ERCPs registered in 2008 was

Discussion

In the present study, we evaluated data from 11,074 ERCPs from GallRiks. The aim of the study was to present a descriptive analysis of hospital caseloads, indications, pathologic findings, cannulation success, sedation techniques, complications, and mortality of ERCPs performed in Sweden. By integrating gallbladder surgery and ERCP in the same database, with a common 30-day follow-up, GallRiks provides a unique opportunity to study the clinical course of gallstone treatment, regardless of

Acknowledgment

The authors acknowledge Melroy A. d'Souza for his valuable input and assistance in preparing the manuscript.

References (12)

There are more references available in the full text version of this article.

Cited by (160)

  • Endoscopic Ultrasound–Guided Biliary Interventions

    2022, Gastrointestinal Endoscopy Clinics of North America
View all citing articles on Scopus

DISCLOSURE: Drs Enochsson, Nilsson, and Löhr were supported by unconditional research funds at the Karolinska Institutet. No other financial relationships relevant to this publication were disclosed.

View full text