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Integrating ERCP Within UK Higher Surgical Training: A Structured, Curriculum-Embedded Model.

Javed Latif1, John Isherwood1, Imran Bhatti2

  • 1Department of Hepatopancreatobiliary Surgery, University Hospitals of Leicester, Leicester.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|April 1, 2026
PubMed
Summary

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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.
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Structured training improves endoscopic retrograde cholangiopancreatography (ERCP) competence in UK surgical trainees. This model overcomes barriers to ERCP exposure, enhancing skills for hepatopancreatobiliary surgery.

Area of Science:

  • Hepatopancreatobiliary (HPB) Surgery
  • Surgical Education
  • Gastroenterology

Background:

  • Structured access to Endoscopic Retrograde Cholangiopancreatography (ERCP) training is limited in UK higher surgical training (HST).
  • Barriers include rota commitments, competing priorities, and restricted endoscopy list access.
  • This study introduces a curriculum-integrated ERCP training model for surgical trainees.

Purpose of the Study:

  • To describe and evaluate a structured ERCP training model within UK HST.
  • To examine systemic factors influencing surgical trainee exposure to ERCP procedures.
  • To identify strategies for overcoming training barriers and informing curriculum development.

Main Methods:

  • A longitudinal case-study approach using prospectively logged data.
Keywords:
ERCP trainingJAG certificationendoscopic retrograde cholangiopancreatographyendoscopy training pathwayhepatopancreatobiliary surgerysurgical education

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  • Analysis of procedural volume, Key Performance Indicators (KPIs), and supervision levels via the JAG Endoscopy Training System (JETS) e-portfolio.
  • Examination of variations in case exposure related to rota, list availability, and training infrastructure.

    • Main Results:

    • 365 ERCP procedures completed over 33 months, exceeding the JAG median of ~300 supervised procedures.
    • Procedural exposure varied by rotation, influenced by service configuration and list access.
    • Key Performance Indicators improved, with >90% native papilla cannulation rates and sustained therapeutic benchmark achievement.

    Conclusions:

    • ERCP competence is achievable within UK HST via integrated training, mentorship, and high-volume endoscopy access.
    • The model offers transferable strategies to overcome systemic barriers in surgical ERCP training.
    • Findings can inform future curriculum development for sustainable ERCP service provision.