Quality standard
Quality statement 2: Urgent endoscopic retrograde cholangiopancreatography within 72 hours
Quality statement 2: Urgent endoscopic retrograde cholangiopancreatography within 72 hours
Quality statement
Adults with common bile duct stones causing jaundice have endoscopic retrograde cholangiopancreatography within 72 hours of diagnosis.
Rationale
Endoscopic retrograde cholangiopancreatography can be used to treat common bile duct stones. Adults should have the procedure performed within 72 hours of diagnosis of common bile duct stones if these are causing jaundice, to prevent further complications such as cholangitis while waiting for treatment.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that adults with common bile duct stones causing jaundice have endoscopic retrograde cholangiopancreatography within 72 hours of diagnosis.
Data source: Local data collection.
Process
Proportion of adults with common bile duct stones causing jaundice who have endoscopic retrograde cholangiopancreatography within 72 hours of diagnosis.
Numerator – the number in the denominator who have endoscopic retrograde cholangiopancreatography within 72 hours of diagnosis.
Denominator – the number of adults with common bile duct stones causing jaundice.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers (such as secondary care services) ensure that healthcare professionals are trained to perform endoscopic retrograde cholangiopancreatography, and that adults can have it within 72 hours of diagnosis of common bile duct stones, if these are causing jaundice.
Healthcare professionals (such as gastroenterologists, radiologists and upper gastrointestinal surgeons) are trained to perform endoscopic retrograde cholangiopancreatography, and provide it for adults within 72 hours of diagnosis of common bile duct stones, if these are causing jaundice.
Commissioners monitor services that offer endoscopic retrograde cholangiopancreatography to ensure that they regularly perform it, and that adults can have this procedure within 72 hours of diagnosis of common bile duct stones, if these are causing jaundice.
Adults with common bile duct stones causing jaundice are able to have an endoscopy (inserting a thin, flexible tube down their throat to perform surgery inside their body) within 72 hours of getting their diagnosis. The endoscopy is to remove the stones in their bile duct (part of the digestive system that is connected to the gallbladder) and prevent other problems such as blockages, inflammation or infection.
Source guidance
Gallstone disease. NICE guideline CG188 (2014), recommendation 1.3.2 (key priority for implementation) and expert consensus