Multicenter Analysis of the Learning Curve for Endoscopic Ultrasound-Guided Gallbladder Drainage: A Cumulative Sum...

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Medical Education

Background:

• Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a vital alternative for patients unsuitable for surgery.
• EUS-GBD presents technical challenges and risks of serious adverse events.
• Understanding the learning curve is crucial for safe and effective EUS-GBD implementation.

Purpose of the Study:

• To evaluate the learning curve for endoscopic ultrasound-guided gallbladder drainage (EUS-GBD).
• To determine the number of procedures required to achieve proficiency in EUS-GBD.
• To assess the impact of experience on procedural outcomes and safety.

Main Methods:

• Analysis of 146 EUS-GBD procedures performed by three endosonographers from January 2016 to January 2024.
• Utilized cumulative sum (CUSUM) analysis to assess learning curves for procedural outcomes.
• Compared outcomes before and after achieving proficiency in procedure time and adverse event rates.

Main Results:

• No significant differences in technical success, clinical success, or adverse events were observed among operators.
• CUSUM analysis indicated proficiency in procedure time was achieved after 27 procedures.
• Proficiency in minimizing adverse events was reached after 23 procedures, with significant improvements in success rates and reduced procedure times post-proficiency.

Conclusions:

• Approximately 23 EUS-GBD procedures are needed to achieve proficiency in minimizing adverse events.
• Around 27 procedures are required to reach proficiency in terms of procedure time for EUS-GBD.
• These findings provide benchmarks for EUS-GBD training and quality improvement.