Cholangioscopy under direct visualization: skill progress during a dedicated Image-Guided Surgery Course

Area of Science:

• Medical training and simulation
• Gastroenterology and Hepatology
• Surgical Education

Background:

• Cholangioscopy is crucial for diagnosing and treating biliary tract diseases like cancer and choledocholithiasis.
• Surgeons underutilize cholangioscopy due to a need for specialized training in laparoscopic and percutaneous techniques.
• Effective training programs are vital for mastering new bile duct clearance methods.

Purpose of the Study:

• To assess skill acquisition and retention in cholangioscopy.
• To evaluate a novel training program utilizing a disposable cholangioscope and a biliary tract model.

Main Methods:

• Prospective study involving 17 physicians (surgeons and interventional radiologists) trained on a biliary tract model with simulated common bile duct stones.
• Participants visualized critical structures and performed stone retrieval using a Dormia basket.
• Skill assessment included task completion time over two days and post-training Likert scale questionnaires.

Main Results:

• All participants successfully completed the cholangioscopic bile duct exploration and stone retrieval task.
• A significant reduction in mean task completion time was observed from day 1 (172s) to day 2 (89s) (P < 0.0001).
• High median ratings (5/5) were reported for the platform's usability, training effectiveness, and realistic simulation.

Conclusions:

• The dedicated cholangioscopy training program effectively enabled bile duct exploration and stone retrieval.
• Significant skill improvement was achieved within two days of training.
• The training platform is user-friendly, simulates realistic scenarios, and accelerates proficiency gain for residents and fellows.