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Related Experiment Videos

Making ERCP training safe: A protocol-based strategy to minimize complications during selective biliary cannulation.

Boon Eu Andrew Kwek1, Tiing Leong Ang, Eng Kiong Teo

  • 1Department of Gastroenterology, Changi General Hospital, Singapore.

Journal of Interventional Gastroenterology
|May 21, 2013
PubMed
Summary

Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...

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Trainee-involved Endoscopic Retrograde Cholangiopancreatography (ERCP) demonstrated high success and low complication rates, similar to expert-only procedures. A protocol-based strategy ensured good clinical outcomes during hands-on training.

Area of Science:

  • Gastroenterology
  • Medical Education
  • Interventional Endoscopy

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) has a notable complication rate (5-10%).
  • Limited data exists on quality indicators for ERCP performed by trainees.
  • This study addresses outcomes of trainee-involved ERCP using a protocol to minimize complications.

Purpose of the Study:

  • To evaluate the outcomes of trainee-involved ERCP procedures.
  • To assess the efficacy of a protocol-based strategy in minimizing complications during selective biliary cannulation by trainees.
  • To compare the safety and efficacy of trainee-involved ERCP with expert-performed ERCP.

Main Methods:

  • A protocol was implemented to guide trainee attempts at selective biliary cannulation.
Keywords:
cholangiopancreatographyeducationendoscopic retrogradequality

Related Experiment Videos

  • Trainee participation was limited to patients with ASA grade ≤ 3.
  • Specific criteria (e.g., 5 failed attempts, 10 minutes, papilla edema, 2 pancreatic duct cannulations) triggered expert takeover.

    • Main Results:

    • Overall technical success rate was 97.9% (98.8% in trainee group vs. 97.6% in expert group).
    • Overall complication rate was 3.9% (3.5% in trainee group vs. 4% in expert group).
    • In the trainee group, inadvertent pancreatic duct cannulation occurred in 14.1%, but acute pancreatitis developed in only 3.5%.

    Conclusions:

    • Trainee-involved ERCP achieved success and complication rates comparable to expert-only procedures.
    • A protocol-based strategy effectively supports safe and successful hands-on training in ERCP.
    • This approach demonstrates good clinical outcomes in trainee-involved ERCP.