EUS and ERCP training in Europe: Time for simulation, optimization, and standardization

Lekkerkerker, Selma J.; Voermans, Rogier P.

doi:10.1002/ueg2.12399

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…Throughout the world, women are highly underrepresented in the field of advanced endoscopy ( 8 ). In this study, however, more women participated than men.…”

Section: Discussionmentioning

confidence: 99%

“…When training individuals in colonoscopy, steeper learning curves and fewer complications have been observed when employing a simulator-based program in training ( 7 ). These benefits have yet to be shown for ERCP ( 8 ). Furthermore, in a recent systematic review on the use of simulators to acquire ERCP skills, only one study conformed with validation criteria ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Saliva stress biomarkers in ERCP trainees before and after familiarisation with ERCP on a virtual simulator

Georgiou,

Boyanov,

Thanasas

et al. 2024

Front. Surg.

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BackgroundStress during the early ERCP learning curve may interfere with acquisition of skills during training. The purpose of this study was to compare stress biomarkers in the saliva of trainees before and after familiarisation with ERCP exercises on a virtual simulator.MethodsAltogether 26 endoscopists under training, 14 women and 12 men, completed the three phases of this study: Phase 1. Three different ERCP procedures were performed on the simulator. Saliva for α-amylase (sAA), Chromogranin A (sCgA), and Cortisol (sC) were collected before (baseline), halfway through the exercise (ex.), and 10 min after completion of the exercise (comp.); Phase 2. A three-week familiarisation period where at least 30 different cases were performed on the virtual ERCP simulator; and Phase 3. Identical to Phase 1 where saliva samples were once again collected at baseline, during, and after the exercise. Percentage differences in biomarker levels between baseline and exercise (Diffex) and between baseline and completion (Diffcomp) during Phase 1 and Phase 3 were calculated for each stress marker.ResultsMean % changes, Diffex and Diffcomp, were significantly positive (p < 0.05) for all markers in both Phase 1 and Phase 3. Diffex in Phase 1 was significantly greater than Diffex in Phase 3 (p < 0.05) for sAA and sCgA. Diffcomp for sAA in Phase 1 was significantly greater than Diffcomp in Phase 3 (p < 0.05). No significant differences were found in sC concentration between Phases 1 and 3.ConclusionThis study shows that familiarisation with the ERCP simulator greatly reduced stress as measured by the three saliva stress biomarkers used with sAA being the best. It also suggests that familiarisation with an ERCP simulator might reduce stress in the clinical setting.

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“…Throughout the world, women are highly underrepresented in the field of advanced endoscopy ( 8 ). In this study, however, more women participated than men.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Saliva stress biomarkers in ERCP trainees before and after familiarisation with ERCP on a virtual simulator

Georgiou,

Boyanov,

Thanasas

et al. 2024

Front. Surg.

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Training and quality indicators in interventional endoscopic ultrasound

Miutescu,

Dhir

2024

Digestive Endoscopy

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Endoscopic ultrasound (EUS) has transformed the landscape of minimally invasive gastrointestinal procedures, necessitating specialized training for proficiency in interventional EUS (iEUS). This study evaluates the effectiveness of iEUS training, focusing on learning curves, success rates, and the associated risks in various procedures, aiming to recommend practices for standardizing training and ensuring competency. Key metrics such as procedure type, learning curve for proficiency, success rates, and risk of adverse events were analyzed to establish benchmarks for training programs. Proficiency in pancreatic fluid collection drainage was achieved after 20–30 procedures, with a 100% success rate and a complication rate ranging from 1.5 to 80%. Gallbladder drainage required 19 cases to reach an 86% success rate, with adverse events reported in 19% of cases. Choledocoduodenostomy mastery was observed after approximately 100 cases, with postintervention pancreatitis affecting 5.3–6.6% of all cases. Hepaticogastrostomy showed a 93% success rate after 33 cases, with a 24.8% adverse event rate. Hepaticoenterostomy reached 100% success beyond the 40th patient, with a 20% rate of postsurgical strictures. Pancreatic duct drainage achieved 89% technical and 87% clinical success after 27 cases, with 12–15% adverse events. Gastro‐enteric anastomosis required 25 cases for proficiency and approximately 40 cases for mastery, with 5.5% immediate and 1% late adverse events. iEUS training outcomes vary significantly across different procedures, highlighting the importance of structured, procedure‐specific training programs to achieve proficiency. These findings provide a foundation for developing universal competency benchmarks in iEUS, facilitating consistent and effective training worldwide.

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Advancements in Research on Challenges in Selective Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography (ERCP)

张

2024

JCPM

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EUS and ERCP training in Europe: Time for simulation, optimization, and standardization

Cited by 3 publications

References 21 publications

Saliva stress biomarkers in ERCP trainees before and after familiarisation with ERCP on a virtual simulator

Saliva stress biomarkers in ERCP trainees before and after familiarisation with ERCP on a virtual simulator

Training and quality indicators in interventional endoscopic ultrasound

Advancements in Research on Challenges in Selective Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography (ERCP)

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