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Related Concept Videos

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When trainees reach competency in performing ERCP: a systematic review.

Neal Shahidi1, George Ou1, Jennifer Telford1

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This summary is machine-generated.

Determining competency in Endoscopic Retrograde Cholangiopancreatography (ERCP) requires a higher number of procedures than current guidelines suggest. Trainees need more ERCP experience to achieve proficiency.

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Area of Science:

  • Gastroenterology
  • Medical Education
  • Surgical Training

Background:

  • Endoscopic Retrograde Cholangiopancreatography (ERCP) is an advanced endoscopic procedure.
  • ERCP is technically demanding and carries a higher risk of adverse events than standard endoscopy.
  • Guidelines vary on the number of ERCPs required for trainee competency assessment.

Purpose of the Study:

  • To assess the learning curve for performing ERCP.
  • To determine the number of ERCP procedures needed to achieve procedural competency.

Main Methods:

  • A systematic literature search of MEDLINE and gray literature was conducted.
  • Included studies reported successful trainee cannulation rates.
  • A successful cannulation rate of 80% or higher was the benchmark for competency.

Main Results:

  • Nine studies involving 137 trainees and 17,100 ERCPs were analyzed.
  • Competency was achieved between 70 and 400 ERCPs across studies.
  • Specific cannulation targets (pancreatic, selective, common bile duct) showed varying ranges for competency achievement, with deep common bile duct cannulation requiring up to 400 procedures.

Conclusions:

  • The evolving therapeutic nature of ERCP has increased procedural complexity.
  • Achieving ERCP competency may require more procedures than currently outlined in North American training guidelines.
  • Advanced endoscopy training programs should re-evaluate their curricula to ensure adequate procedural competency.