Liver medicine quality indicator

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Date: 20 December 2024

Time: 05:51

Liver medicine quality indicator

Percentage of patients who have endoscopic retrograde cholangio-pancreatography (ERCP) and develop pancreatitis

What is ERCP?

Endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure which involves putting an endoscope (camera) down through the gullet to place instruments into the bile ducts or pancreatic duct. UHB performs approximately 400 of these procedures per year to treat conditions such as bile duct stones, gallstone pancreatitis, narrowing of the bile ducts and cancers.

Pancreatitis is inflammation of the pancreas which usually presents as severe pain in the abdomen. It can occur for several reasons, but one of these is as a complication following ERCP.

How is the Trust doing?

Rolling year to date (February 2019 – January 2020)	0.9%
Rolling 2 years (February 2018 – January 2020)	1.4%

The post-ERCP pancreatitis rate remains very low at UHB and below the national average.

Why is this indicator important?

ERCP is often a very beneficial procedure but does have some risks. One of these is the risk of pancreatitis following the procedure which causes abdominal pain, can delay discharge and sometimes lead to more serious problems. The average rate of post-ERCP pancreatitis is approximately 5% as demonstrated by the national audit of ERCP undertaken by the British Society of Gastroenterology in the United Kingdom. It is therefore important that UHB is not significantly above this rate.

How do we measure this indicator?

Patients who develop pancreatitis (identified through a rise in the level of the enzyme amylase >400 IU/l in the blood) within 5 days of having an ERCP. Known gallstone pancreatitis patients are excluded from the indicator.

Where does this data come from?

Patients who have undergone an ERCP are identified in Unisoft (liver database) and then checked against Oceano (patient administration system) to see if they developed pancreatitis. Patients are only identified as having pancreatitis if they also have an amylase level of >400 within 30 days of ERCP discharge – this is checked in PICS (Patient Information and Communication System).