Are we meeting the standards set for endoscopy? Results of a large-scale prospective survey of endoscopic retrograde cholangio-pancreatograph practice

ERCP Educational Guidelines for Fellows

“…However, the implication that this is an appropriate threshold for surgery fellows or, indeed, for any ERCP trainee, has been challenged (25). Furthermore, the notion that the completion of 200 procedures constitutes a reasonable threshold for achieving competence may be unrealistic in light of a survey of ERCP practice in the United Kingdom, which reported a cannulation rate of only 66% among senior trainees who had completed more than 200 ERCPs (13). Therapeutic interventions: The most common procedures performed during ERCP are stone extraction, relief of biliary obstruction and stent placement for bile leaks.…”

“…However, subsequent studies (12,13) have reported that success rates of over 80% for deep biliary cannulation might not be achieved until trainees have performed more than 300 to 400 procedures. An analysis (14) of outcomes, based on endoscopists' experience, found that learning endoscopic sphincterotomy techniques required a minimum of 40 procedures, but the complication rate decreased further after 100 procedures.…”

ERCP practitioners in China: results from national surveys in 2007 and 2013

“…In that survey, shortage of ERCP endoscopists (ERCPists) was suggested to be a main factor restricting the development of the ERCP service. Moreover, in most developed countries, endoscopists intending to perform ERCP are required to undergo a standardized advanced endoscopic training program to obtain technical competence [5,6], whereas China has no national standard for ERCPists or trainees, and the training pathway of ERCPists is unknown. Therefore, a survey to investigate the status of Chinese ERCPists would be beneficial for development of the ERCP service and the establishment of a standard training program.…”

Quality matters: A protocol-based strategy in ERCP training

“…Is it every time the cannulation device touches the papilla? (2) What is meant by the pancreatic duct cannulation? With wire or contrast or either?…”

“…1,2 There are a number of quality indicators for ERCP, two of which are cannulation of the duct of interest (intraprocedure) and complication rate (postprocedure). 3 The medical literature has shed some light on these issues as they pertain to ERCP training.…”