预测ERCP手术时间--瑞典ERCP时间估算(SWEET)工具。

IF 11.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Endoscopy Pub Date : 2025-01-01 Epub Date: 2024-08-07 DOI:10.1055/a-2371-1367
Alexander Waldthaler, Anna Warnqvist, Josefine Waldthaler, Miroslav Vujasinovic, Poya Ghorbani, Erik von Seth, Urban Arnelo, Mathias Lohr, Annika Bergquist
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引用次数: 0

摘要

背景:内镜逆行胰胆管造影术(ERCP)的持续时间受多种因素影响。本研究旨在描述ERCP时间的影响因素,并创建一个用于干预前估算ERCP时间的工具:方法:从瑞典国家质量登记处(GallRiks)提取了2010年至2019年进行的74 248例ERCP的数据,使用线性回归分析和均方根误差(RMSE)作为损失函数,确定了预测ERCP时间的变量。十个变量被组合在一起,形成了ERCP持续时间的估算工具。利用 2020 年至 2021 年的 9472 例 ERCP 对该工具进行了外部验证:结果:ERCP平均(标清)时间为36.8(25.3)分钟。对ERCP时间影响最大的适应症是原发性硬化性胆管炎和慢性胰腺炎。肝门和肝内胆道狭窄以及对胰管的干预是对ERCP时间影响最大的解剖特征。影响最大的手术步骤是导管内镜检查、碎石、扩张和乳头切开术。基于这些结果,我们建立并验证了 SW:edish E: stimation of E:RCP T:ime(SWEET)工具,该工具基于 10 个因素的评分系统(例如,胆管插管 5 分钟,胰管插管 15 分钟),在外部验证期间,预测的 ERCP 时间与实际时间平均相差 17.5 分钟:基于对ERCP时间影响因素的新认识,我们创建了SWEET工具,这是首个用于干预前估算ERCP时间的特定工具,易于在日常临床实践中应用,可指导有效的ERCP时间安排。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predicting ERCP procedure time - the SWedish Estimation of ERCP Time (SWEET) tool.

Background: The duration of an endoscopic retrograde cholangiopancreatography (ERCP) is influenced by a multitude of factors. The aim of this study was to describe the factors influencing ERCP time and to create a tool for preintervention estimation of ERCP time.

Methods: Data from 74 248 ERCPs performed from 2010 to 2019 were extracted from the Swedish National Quality Registry (GallRiks) to identify variables predictive for ERCP time using linear regression analyses and root mean squared error (RMSE) as a loss function. Ten variables were combined to create an estimation tool for ERCP duration. The tool was externally validated using 9472 ERCPs from 2020 to 2021.

Results: Mean (SD) ERCP time was 36.8 (25.3) minutes. Indications with the strongest influence on ERCP time were primary sclerosing cholangitis and chronic pancreatitis. Hilar and intrahepatic biliary strictures and interventions on the pancreatic duct were the anatomic features that most strongly affected ERCP time. The procedure steps with most influence were intraductal endoscopy, lithotripsy, dilation, and papillectomy. Based on these results, we built and validated the SW: edish E: stimation of E: RCP T: ime (SWEET) tool, which is based on a 10-factor scoring system (e.g. 5 minutes for bile duct cannulation and 15 minutes for pancreatic duct cannulation) and predicted ERCP time with an average difference between actual and predicted duration of 17.5 minutes during external validation.

Conclusions: Based on new insights into the factors affecting ERCP time, we created the SWEET tool, the first specific tool for preintervention estimation of ERCP time, which is easy-to-apply in everyday clinical practice, to guide efficient ERCP scheduling.

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来源期刊
Endoscopy
Endoscopy 医学-外科
CiteScore
5.80
自引率
11.80%
发文量
1401
审稿时长
2 months
期刊介绍: Endoscopy is a leading journal covering the latest technologies and global advancements in gastrointestinal endoscopy. With guidance from an international editorial board, it delivers high-quality content catering to the needs of endoscopists, surgeons, clinicians, and researchers worldwide. Publishing 12 issues each year, Endoscopy offers top-quality review articles, original contributions, prospective studies, surveys of diagnostic and therapeutic advances, and comprehensive coverage of key national and international meetings. Additionally, articles often include supplementary online video content.
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