Kats, I. (Iris) (2017) Kwaliteit van de hepato-pancreatico-biliaire diagnostiek en interventie in het Medisch Spectrum Twente in de periode 2011-2016 : Een retrospectief database onderzoek. thesis, Medicine.
Full text available on request.Abstract
Objectives: the main objective of this study was to provide insight in the quality and success of endoscopic retrograde cholangiopancreaticography’s (ERCP) and endoscopic ultrasonography’s (EUS) performed in Medisch spectrum Twente (MST). With this insight we will evaluate indication and outcome of these procedures, with potential effect on treatment strategies and clinical practice. Methods: a retrospective, database study was performed. The database consists of all patients who underwent ERCP or EUS between January 2011 and December 2016 who met our inclusion criteria, not meeting one of our exclusion criteria. The gathered data was statistically analysed, in order to answer our predefined research questions. Results: ERCP: cannulation was successful in 88.4% of cases. The percentage of successful cannulations differs significantly between endoscopists. 86.6% of the patients suspected for common bile duct stones (CBDS) were completely stone-free after ERCP. 69.3% of patients with a biliary stricture received successful treatment. In 79.3% of the patients suspected of bile duct injury successful treatment was established. EUS: in 50% of patients with a negative transabdominal ultrasound, EUS lead to diagnosis of gallbladder stones. EUS had a positive and negative predictive value for CBDS of 75.7% and 97.1%, respectively. EUS confirmed the suspected diagnosis of chronic pancreatitis in 38-46.8% of patients. In 54.3% of patients undergoing EUS due to an episode of acute pancreatitis of unknown origin, an origin was determined. The nature of a suspicious pancreatic cyst at the time of EUS, was confirmed after pathologic analysis of the resected material in 68.8% of patients. Conclusion: The quality of ERCP and EUS in our centre is generally considered to be in line with prevailing universal standards. In some areas, improvement of quality could be achieved. Improvement on the short term might specifically be possible in the percentage of successful cannulation during ERCP, by rearranging the performance standards for our endoscopists, and for the treatment of biliary strictures, by establishing new treatment options, that don’t require cannulation.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Venneman, dr. N. G. MDL-arts and Locatie: Maag-, Darm- en Leverziekten |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:55 |
| Last Modified: | 25 Jun 2020 10:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1601 |
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