Introduction While ERCP is a common therapeutic procedure, to date no studies have ever been conducted which examine its availability, the types of technique or nature of training. This is a prospective study which uses descriptive data from NHS hospitals in England.
Methods Between February and August 2015 a questionnaire was sent to consultants who perform ERCP. Further information was obtained from support staff by telephone, email or freedom of information request. The questions concerned the number of dedicated ERCP lists, personnel performing ERCP, the techniques used, the type of anaesthesia or sedation available, opportunities for trainees and availability of dedicated training lists.
Results 146 trusts were contacted and 126 consultants responded. These consultants provided ERCP services for 170 hospitals. Not all questions were answered.
Hospitals: 139 hospitals (82%) offered ERCP services of between 1 and 10 lists per week (mean 2.8, mode 2), though 1 hospital did not have a dedicated list. All 31 hospitals that did not offer ERCP (18%) did have access via a neighbouring hospital, usually within the same trust.
Practitioners: Of the 373 practitioners who performed ERCP, 316 (85%) were physicians, 46 (12%) surgeons, 7 (1%) radiologists, 1 nurse and 3 unspecified. The number of practitioners per hospital ranged between 1 and 7, though most hospitals had 2.
Trainees: Of the 139 hospitals performing ERCP, 69 (50%) had trainees, but only 33 (48%) of these had dedicated training lists.
Techniques: Most hospitals (121/136; 89%) use short wire technique, while 69 (51%) use long wire and 54 (40%) use both. 110 hospitals practice post sphincterotomy balloon sphincteroplasty (81%).
Sedation: Propofol sedation was available for ERCP in only 46/136 (34%) hospitals and general anaesthetic was available in only 70 (51%) hospitals. 90/136 (66%) hospitals had no access to propofol and 66/136 (49%) hospitals had no access to a general anaesthetic list.
Conclusion This point prevalence study has shown that ERCP is widely available in England. Physicians perform the majority of ERCPs. Only 69 hospitals (50%) were training practitioners. Although relatively new, both short wire technique and post sphincterotomy balloon sphincteroplasty are commonly used. Only a quarter of hospitals had propofol lists for ERCP, despite guidance from the British Society of Gastroenterology and the Royal College of Anaesthetists 2011.1,2
Disclosure of Interest None Declared