A joint task force from the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology has released an updated set of ERCP quality indicators, reflecting how evidence, risk tolerance, and expectations around value have shifted since the last update in 2015.
The message is subtle but firm: ERCP remains one of GI’s most operator-dependent — and highest-risk — procedures, and variation in practice is no longer acceptable. The revised framework spans the full episode of care, from stricter indications before the procedure, to technical benchmarks during ERCP, to outcomes that matter to patients and health systems after discharge.
Several updates stand out. The task force endorses a narrower approach to ERCP indications, near-universal use of rectal NSAIDs for pancreatitis prevention in appropriate patients, and — for the first time — formal tracking of prophylactic pancreatic stent use in high-risk cases. Rather than focusing only on adverse event rates, the document emphasizes consistent documentation and longitudinal tracking, signaling a shift toward continuous quality improvement over punitive thresholds.