NURSE TRIAGE IN COMPLICATIONS OF ENDOSCOPIC RETROGRADE CHOLEDOCHOPANCREATOGRAPHY

ERCP ili endoskopska retrogradna kolangiopankreatografija je invazivna pretraga koja koristi kombinaciju endoskopije i dijaskopije sa ciljem vizualizacije i/ili intervencije u području pankreasnih i žučnih vodova. Pretragom se provodi niz terapijskih postupaka: endoskopska sfinkterotomija sa ekstrakcijom konkremenata, postavljanje i zamjena stentova kod opstrukcije pankreasnih i žučnih vodova, drenaža žuči, drenaža detritusa i konkremenata, citološko uzorkovanje suspektnih patoloških promjena (uzimanje brisa četkicom). To je invazivna pretraga koja nosi sa sobom određene rizike razvoja komplikacija. Procjena stanja pacijenta, kontinuirana sestrinska skrb nakon ERCP-a, specifična znanja i vještine medicinske sestre su važne u prepoznavanju komplikacija nakon samog zahvata. Naše istraživanje je provedeno na Zavodu za gastroenterologiju KB Split. U njemu su obrađene komplikacije ERCP-a u razdoblju od siječnja 2017. godine do prosinca 2019.godine u svih pacijenata podvrgnutih ERCP-u. Korištena je medicinska dokumentacija knjige protokola, pismohrana povijesti bolesti Zavoda za gastroenterologiji i hepatologiju KBC-a Split, liječnička otpusna pisma iz bolničkog informacijskog sustava (BIS), te sestrinske dokumentacije BIS-a. Cilj rada bio je utvrditi učestalost komplikacija ERCP-a i njihovu korelaciju s dobi, spolom, uputnom dijagnozom i kormobiditetima pacijenata. Rezultati provedenog istraživanja pokazali su da se unatoč konstantnom povećanju broja napravljenih ERCP-a u KBC Split, učestalost komplikacija (post-ERCP pankreatitis, krvarenje iz gastrointestinalnog trakta, perforacija šupljih organa, ostale komplikacije) ne povećava, te da je usporediva s onom većine svjetskih centara.Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive method which uses a combination of endoscopy and diascopy to vizualize and/or intervene in the area of pancreatic or biliary ducts. This method is intended to perform a series of therapeutic procedures: endoscopic sphincterotomy with concrement extraction, insertion and replacment of stents in pancreatic or biliary ducts obstruction, drainage of bile, drainage of debris and concrements, citologic sampling of suspicious pathologic changes (brushing). This is an invasive procedure which carries certain risk for development of complications. The assessment of patient's condition, continuous care after ERCP, nurse's specific knowledge and skills are of utmost importance in recognizing of complications after the procedure. Our study was conducted at the Department of gastroenterology, Unversity hospital Split. It analysed the complications of ERCP during time period from January 2017. to December 2019., in all patients who underwent ERCP. In this study, we used data from admition protocol book, the archive of the Departmen of gastroenterology, University hospital Split, patients' discharge letters from hospital information system (BIS) and nursing documantation from BIS. The aim of this study was to assess the incidence of ERCP complications as well as their correlation with age, gender, initial diagnosis and comorbidities of patients. Our results showed that, despite constant increase of number of performed ERCP at University hospital Split, the incidence of complications (post- ERCP pancreatitis, gastrointestinal bleeding, hollow organ perforation, other complications) hadn't increased, and is comparable to most endoscopic world centres