{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:23:27Z","timestamp":1788560607578,"version":"build-2803163510"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Die Endoskopische retrograde Cholangio-Pankreatikografie [ERCP] ist eine komplexe Prozedur mit flacher Lernkurve, die mit den Risiken ernsthafter Komplikationen, wie der Pankreatitis, der Blutung, der Cholangitis und der Perforation einhergeht. So sollte zur pr\u00e4zisen Indikationsstellung der risikoreicheren ERCP auch die Endsonografie angeboten werden. Zahlreiche Faktoren beeinflussen den Erfolg der ERCP. Neben einer strukturierten Ausbildung zum Kompetenzerwerb mit einer Mindestzahl an ERCPs unterschiedlicher Schwierigkeitsgrade, erfordert die Aufrechterhaltung einer guten Qualit\u00e4t der ERCP auch eine regelhafte Mindestanzahl durchgef\u00fchrter Untersuchungen pro Jahr. Es existiert mittlerweile eine umfangreiche Evidenz, die eine signifikante Korrelation der ERCP-Volumina mit den prim\u00e4ren Erfolgsraten, niedrigeren Krankenhausverweildauern, weniger ungewollten Wiederaufnahmen sowie geringeren Komplikationen zeigt. Die Grenzen zur Unterscheidung zwischen Hochvolumen- und Niedrigvolumen-Zentren wurden in den Studien uneinheitlich gew\u00e4hlt, die h\u00f6chste Evidenz liegt f\u00fcr einen Grenzwert von 200 ERCPs\/Jahr vor. Die Frage nach einer Spezialisierung in der ERCP hat einen aktuellen Bezug erhalten durch die derzeitigen Entwicklungen der Krankenhausreform. Hier soll eine Mindestvorhaltezahl f\u00fcr Leistungsgruppen definiert werden. Eine Mindestvorhaltezahl allein wird aber keine gute Behandlungsqualit\u00e4t erreichen k\u00f6nnen. Im Sinne einer qualitativ hochwertigen Patientenversorgung ist es notwendig, dass die ERCP in der spezialisierten Gastroenterologie angeboten wird, die vor dem Hintergrund der Krankenhausreform in der Leistungsgruppe \u201eKomplexe Gastroenterologie\u201c zugeordnet wird, die neben einer ausreichenden Anzahl an ERCPs zur Weiterbildung und zum Kompetenzerhalt, einen Rufdienst und komplement\u00e4re Verfahren wie die EUS anbieten und die in angemessen erreichbaren Kliniken eingebettet sind, die \u00fcber die notwendigen Ressourcen zum Komplikationsmanagement verf\u00fcgen.<\/jats:p>","DOI":"10.1055\/a-2350-1930","type":"journal-article","created":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T22:59:59Z","timestamp":1723071599000},"page":"1224-1228","source":"Crossref","is-referenced-by-count":6,"title":["Einfluss der Spezialisierung auf prim\u00e4re Erfolgs- sowie Komplikationsrate bei der ERCP. Vorschlag zur Verbesserung der\u00a0Qualit\u00e4t der ERCP"],"prefix":"10.1055","volume":"62","author":[{"given":"Ludger","family":"Leifeld","sequence":"additional","affiliation":[{"name":"Medizinische Klinik 3 \u2013 Allgemeine Innere Medizin und Gastroenterologie, St Bernward Krankenhaus, Hildesheim, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Jakobs","sequence":"additional","affiliation":[{"name":"Medizinische Klinik C mit Schwerpunkt Gastroenterologie, Klinikum Ludwigshafen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Frieling","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Denzer","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Gastroenterologie, Endokrinologie, Stoffwechsel und klinische 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