Training in ERCP and EUS in the UK anno 2017

Area of Science:

• Gastroenterology
• Medical Training
• Endoscopic Procedures

Background:

• Endoscopic retrograde cholangiopancreatography (ERCP) has transitioned from a diagnostic to a predominantly therapeutic tool over the past two decades.
• Endoscopic ultrasound (EUS) is increasingly utilized for therapeutic interventions, expanding its clinical applications.
• The effectiveness and safety of both ERCP and therapeutic EUS are significantly influenced by the operator's technical proficiency.

Purpose of the Study:

• To highlight the evolving therapeutic roles of ERCP and EUS.
• To emphasize the critical importance of operator technique in EUS diagnostic accuracy and ERCP/EUS therapeutic safety.
• To advocate for enhanced training and certification standards for ERCP and EUS in the UK.

Main Methods:

• This is a review and perspective piece, not an experimental study.
• Analysis of the evolution of ERCP and EUS in clinical practice over the last 20 years.
• Discussion of the impact of operator skill on procedural outcomes.

Main Results:

• ERCP is now almost exclusively a therapeutic procedure.
• EUS is demonstrating expanding therapeutic capabilities.
• Operator expertise is paramount for achieving accurate diagnoses with EUS and ensuring safe, effective therapeutic interventions with both ERCP and EUS.

Conclusions:

• Effective training programs are essential for developing and maintaining operator competence in ERCP and EUS.
• Robust standards for certification and revalidation are necessary to guarantee the highest levels of safety and efficacy for ERCP and EUS procedures in the UK.
• Continuous improvement in training and standards is crucial as these endoscopic techniques continue to advance therapeutically.