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Technical Detail for Robot Assisted Pancreaticoduodenectomy

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Assessment of technical competence during ERCP training

J L Watkins¹, K P Etzkorn, T E Wiley

¹University of Illinois at Chicago, Department of Medicine, USA.

Gastrointestinal Endoscopy

|October 1, 1996

Summary

This study shows that while initial endoscopic retrograde cholangiopancreatography (ERCP) skills improve rapidly, reaching proficiency for pancreatic and common bile duct cannulation requires at least 100 procedures.

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Published on: August 11, 2023

Area of Science:

Gastroenterology
Medical Education
Surgical Skills Training

Background:

Endoscopic retrograde cholangiopancreatography (ERCP) requires advanced technical skills.
Current competency assessment methods for ERCP are not evidence-based.
Previous recommendations for training volume lack prospective data.

Purpose of the Study:

To prospectively evaluate the learning curve for ERCP skills.
To establish data-driven recommendations for ERCP training volume.

Main Methods:

Prospective data collection of pancreatic and common bile duct cannulation rates over 6 years.
Involved 21 trainees and 9 proctors in a university training program.
Analysis of learning curves based on procedure count.

Main Results:

Trainees performed an average of 31 ERCP procedures (range 10-96).
Rapid skill improvement observed up to the 40th procedure.
Proficiency (85% success) for pancreatic duct cannulation reached by the 70th procedure, and for common bile duct cannulation not until after 100 procedures.

Conclusions:

The study provides the first prospective data on ERCP skill acquisition.
Learning curves suggest a need for at least 100 procedures for proficiency.
Data supports revising training guidelines for ERCP competency.