ERCP in acute XXXX : What takes place in routine clinical practice?

@entity1 @entity788 @entity255 @entity1087
AIM: To evaluate the data from a survey carried out in Italy regarding the endoscopic approach to acute @entity788 in order to obtain a picture of what takes place after the release of an educational project on acute @entity788 sponsored by the Italian Association for the Study of the Pancreas. METHODS: Of the 1 173 @entity1 enrolled in our survey, the most frequent etiological category was biliary forms (69.3%) and most @entity1 had mild @entity788 (85.8%). RESULTS: 344/1 173 (29.3%) underwent endoscopic retrograde cholangiopancreatography (ERCP). The mean interval between the onset of symptoms and ERCP was 6.7    5.0 d; only 89 examinations (25.9%) were performed within 72 h from the onset of symptoms. The main indications for ERCP were suspicion of common bile duct stones (90.3%), @entity1087 (44.5%), clinical worsening of acute @entity788 (14.2%) and @entity255 (6.1%). Biliary and pancreatic ducts were visualized in 305 @entity1 (88.7%) and in 93 @entity1 (27.0%) respectively. The success rate in obtaining a cholangiogram was statistically higher (P = 0.003) in @entity1 with mild acute @entity788 (90.6%) than in @entity1 with severe disease (72.2%). Biliary endoscopic sphincterotomy was performed in 295 of the 305 @entity1 (96.7%) with no difference between mild and severe disease (P = 0.985). ERCP morbidity was 6.1% and mortality was 1.7%; the mortality was due to the complications of acute @entity788 and not the endoscopic procedure. CONCLUSION: The results of this survey, as with those carried out in other countries, indicate a lack of compliance with the guidelines for the indications for interventional endoscopy.
