1
|
Chen JH, Wang HP. Endoscopic retrograde cholangiopancreatography training and education. Dig Endosc 2024; 36:74-85. [PMID: 37792821 DOI: 10.1111/den.14702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/02/2023] [Indexed: 10/06/2023]
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic technique used to diagnose and treat biliary and pancreatic diseases. It is one of the most technically demanding endoscopic procedures. ERCP training programs must ensure trainees have adequate knowledge of the anatomy and physiology associated with biliopancreatic diseases. The variety of ERCP procedures included in training programs should provide sufficient basic training for novice trainees and advanced training for experienced endoscopists. The main endoscopic procedures should be trained in ascending order of difficulty. Incorporating models capable of simulating various clinical and anatomical conditions could provide an effective means of fulfilling training requirements, although they are not easily available due to expensive facilities and void of standard assessment. Competency assessment is crucial in ERCP training to ensure trainees can independently and safely perform ERCP. Because of the rapid advancement of diagnostic and therapeutic methods, postgraduate training is critical for ERCP practitioners. Once certificates are attained, practitioners are solely responsible for maintaining their competency, credentialing, and quality.
Collapse
Affiliation(s)
- Jiann-Hwa Chen
- Department of Internal Medicine, Tzu Chi University College of Medicine, Hualien, Taiwan
- Taipei Tzu Chi Hospital, Taipei, Taiwan
| | - Hsiu-Po Wang
- Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| |
Collapse
|
2
|
Gimenez ME, Uribe Rivera AK, Montanelli J, Swanström LL, Mutter D, Seeliger B. Cholangioscopy under direct visualization: skill progress during a dedicated Image-Guided Surgery Course. Surg Endosc 2023; 37:8116-8122. [PMID: 37658199 DOI: 10.1007/s00464-023-10357-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/30/2023] [Indexed: 09/03/2023]
Abstract
AIMS Training programs are essential to introduce new methods for bile duct clearance. Visual examination via cholangioscopy is ideal to diagnose and treat biliary tract diseases such as cancer and choledocholithiasis. However, surgeons rarely use cholangioscopes. Specific training is required to master laparoscopic and percutaneous cholangioscopy. This study aims to assess skill acquisition and retention during cholangioscopy training in the Image-Guided Therapies Masterclass. METHODS This prospective study enrolled 17 physicians undergoing training in interventional treatments of biliary diseases. A novel disposable cholangioscope and access kit were used with a biliary tract model including two simulated common bile duct (CBD) stones. The curriculum required visualization of all critical structures before removal of one stone with a Dormia basket. After informed consent, demographic data and time to exercise completion were recorded on each of two subsequent training days. Task-specific questions were measured at the completion of training using a Likert scale (strongly disagree to strongly agree, 1-5 points). RESULTS All participants successfully completed the task (6F/11 M, age 36 ± 5 years; 13 surgeons, 4 interventional radiologists; median experience with percutaneous procedures 2 years, range 0-20). Significant improvement in mean task completion time was observed (day 1: 172 ± 59 s, day 2: 89 ± 45 s; P < 0.0001). All task-specific questions were answered with a median rating of 5/5: "The platform facilitates cholangioscopy" and "This training method accelerates gain in proficiency and is useful for residents/fellows" (IQR 5-5), "This platform is useful to measure the proficiency level" and "There is an application for simulation in percutaneous surgery training" (IQR 4.5-5), "The platform is user-friendly" and "The model quality recreates realistic scenarios" (IQR 4-5). CONCLUSION Cholangioscopic bile duct exploration and stone retrieval were achieved by all participants using a dedicated training program and physical simulator. Significant skill progress was observed during 2 days of dedicated training.
Collapse
Affiliation(s)
- M E Gimenez
- Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France.
- DAICIM Foundation (Training, Research and Clinical Activity in Minimally Invasive Surgery), Buenos Aires, Argentina.
- Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France.
| | - A K Uribe Rivera
- Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France
| | - J Montanelli
- Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France
| | - L L Swanström
- Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France
| | - D Mutter
- Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France
- Department of Digestive and Endocrine Surgery, University Hospitals of Strasbourg, Strasbourg, France
- Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France
| | - B Seeliger
- Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France
- Department of Digestive and Endocrine Surgery, University Hospitals of Strasbourg, Strasbourg, France
- Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France
- ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France
- Institute for Viral and Liver Diseases, Inserm U1110, Strasbourg, France
| |
Collapse
|
3
|
Weigt J, Kandulski A, Malfertheiner P. Technical improvement using ultra-slim gastroscopes for direct peroral cholangioscopy: analysis of the initial learning phase. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2014; 22:74-8. [DOI: 10.1002/jhbp.169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Jochen Weigt
- Department of Gastroenterology, Hepatology and Infectious Diseases; Otto-von-Guericke University; Leipziger Str. 44 39120 Magdeburg Germany
| | - Arne Kandulski
- Department of Gastroenterology, Hepatology and Infectious Diseases; Otto-von-Guericke University; Leipziger Str. 44 39120 Magdeburg Germany
| | - Peter Malfertheiner
- Department of Gastroenterology, Hepatology and Infectious Diseases; Otto-von-Guericke University; Leipziger Str. 44 39120 Magdeburg Germany
| |
Collapse
|
4
|
Weigt J, Kandulski A, Malfertheiner P. Direct peroral cholangioscopy using ultraslim gastroscopes: high technical performance with important diagnostic yield. Gastrointest Endosc 2014; 79:173-7. [PMID: 24342591 DOI: 10.1016/j.gie.2013.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 07/07/2013] [Indexed: 02/08/2023]
Affiliation(s)
- Jochen Weigt
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-v.-Guericke University Magdeburg, Magdeburg, Germany
| | - Arne Kandulski
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-v.-Guericke University Magdeburg, Magdeburg, Germany
| | - Peter Malfertheiner
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-v.-Guericke University Magdeburg, Magdeburg, Germany
| |
Collapse
|