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• W2085485265 abstract "Évaluer la cholangiopancréatographie rétrograde endoscopique dans les Hôpitaux généraux. Étude prospective des CPRE effectuée dans 28 centres sur 18 mois. La réussite était jugée à J 1; la morbidité et la mortalité étaient appréciées au 30e jour. 2 708 CPRE ont été recensées sur les 28 centres. Le taux de succès était de 92,1 % et était plus élevé pour les centres ayant effectué plus de 200 actes (OR 2,07 [1,52-2,86]). La réussite thérapeutique était corrélée à un diamètre de la VBP > 6 mm (OR 9,1 [7,15-11,57]) et à l’activité du centre (OR 1,91 [1,38-2,6]). Le taux de complication et de décès étaient respectivement de 9,1 % et 4 % avec une mortalité spécifique de 0,8 %. La morbidité était plus faible pour les centres ayant effectués plus de 200 actes (OR 0,36 [0,220,6]) et en cas d’examen jugé facile (OR 0,5 [0,35-0,74]). La mortalité dépendait du score ASA du malade (OR pour les patients ASA 2, 3, 4 de 9 [1-66], 53,3 [7,3-392] et 164,7 [21,7-1249], respectivement), de la survenue d’une complication (OR = 3,9 [1,96-7,78]), du diamètre de la VBP, et du succès technique (OR = 0,49 [0,27-0,88]). Cette étude montre que la réussite de la CPRE et la morbidité dépendent essentiellement du volume d’activité du centre alors que la mortalité est fortement liée au score ASA du malade. Evaluate endoscopic retrograde cholangiopancreatography (ERCP) in general hospitals in France. 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. 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]). 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." @default.
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• W2085485265 date "2007-09-01" @default.
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• W2085485265 title "Evaluation of endoscopic retrograde cholangiopancreatography procedures performed in general hospitals in France" @default.
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• W2085485265 doi "https://doi.org/10.1016/s0399-8320(07)91936-3" @default.
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