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 21 May 2018

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News

Diagnostic use of ERCP has declined in the USA

The use of diagnostic ERCP in the USA has steadily declined since the advent of noninvasive diagnostic techniques, finds May's issue of the American Journal of Gastroenterology.

News image

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Dr Mazen Jama and colleagues from California evaluated nationwide trends in the utilization of endoscopic retrograde cholangiopancreatography (ERCP).

The research team assessed the use of ERCP in relation to the advent of noninvasive methods of visualizing the biliary and pancreatic tree.

The team used the Nationwide Inpatient Sample database to calculate the age-adjusted rate for ERCP performed from 1988 to 2002.

Outpatient ERCP declined from 25 to 16 per 100,000 by 2003
American Journal of Gastroenterology

The researchers accessed the State Ambulatory Surgery Database to evaluate trends in outpatient ERCP from 1997 to 2003.

The team undertook linear Poisson multivariate regression model to control for variations in age, gender, and ethnicity among the overall patient population.

The Nationwide Inpatient Sample database contained 402,343 patients who had an ERCP performed from 1988 to 2002.

The research team reported that the mean age for these patients was 60 years old.

From 1988 to 1996, the age-adjusted rate for ERCP increased by nearly 3-fold, from 26 per 100,000 in 1988 to 75 in 1996.

The team found the rate for ERCP declined from 75 in 1996 to 60 by the year 2002.

The rates of diagnostic ERCP in men and women were 27 and 32 per 100,000 in 1988 and 1990, respectively.

The researchers noted that this rate then increased to 36 and 43 per 100,000 in 1994 and 1996, which then declined to 29 between 2000 and 2002.

The age-adjusted rate for therapeutic ERCP in men and women was 14 and 17 per 100,000 in 1988 and 1990, respectively.

The team observed that this continued to increase throughout the time span from 39 in 2000 to 44 in 2002.

The State Ambulatory Surgery Database revealed a continual decline in outpatient ERCP from 25 per 100,000 in 1997 down to 16 per 100,000 in the year 2003.

Dr Jama's team concluded, "The utilization of ERCP dramatically increased from 1988 to 1996."

"However, since the advent of noninvasive diagnostic techniques such as endoscopic ultrasound, and magnetic resonance cholangiopancreatography, there has been a steady decline in the utilization of diagnostic ERCP from 1996 to 2002."

Am J Gastroenterol 2007: 102(5): 966-75
08 May 2007

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