The first evaluation of performance after informal training in Endoscopic retrograde cholangiopancreatography.

Abstract

Background : Successful performance of diagnostic and therapeutic ERCP requires skillful manipulation of the side view duodenoscope and accessories. Increased need for ERCP has led experienced endoscopists to seek advanced training in this highly skilled procedure, and has resulted in the development of guidelines from the American Society for Gastrointestinal Endoscopy regarding appropriate experience,skill, and training before performing ERCP. Recommendations for the number of examinations has ranged from 35-200 case, made without the benefit of prospective data.

Purpose : The aim of this study was to objectively determine the number of diagnostic ERCP required attaining minimum technical competence and evaluation of performance after informal training in endoscopic retrograde cholangiopancreatography.

Method : Common bile duct cannulation rate was retrospectively recorded for 107 cases in Prapokkloa hospital. The success rate learning curves was constructed.

Result : Performed ERCP 107 examinations about 2 years. For common bile duct cannulation,there was a linear rise of the successfull learning curves.

Conclusion : This is the first retrospective evaluation of acquisition of skills in ERCP of Prapokkloa hospital . The 85 percent level of common bile duct cannulation is not reached until the ninetieth procedure. This data suggest a threshold of at least 90 procedures of diagnostic ERCP required attaining minimum technical competence.