How long does it take to be an ERCP expert?
Ozan Andaç ErbilDepartment of General Surgery, Medar Gebze Hospital, Kocaeli, TurkeyINTRODUCTION: Although many researches have been done on the success and complications of the endoscopic retrograde cholangiopancreatography (ERCP) procedure, the effects of the endoscopist’s experience are still a controversial issue.
METHODS: Between January 2016 and January 2020, 320 ERCP procedures with natural papilla performed sequentially by a single endoscopist were divided into 4 groups only in chronological order. Medical records from the hospital automation system and ERCP forms were reviewed retrospectively. The effects of experience on the ERCP procedure were investigated by comparing the success rate and complications between the groups.
RESULTS: In the procedures carried out on 320 native papilla, success rate was 88.43%; the success rates of selective biliary cannulation in four groups were, respectively, 83.75, 93.75, 88.75, and 87.50%. It was determined that success rate did not increase by increasing experience (p=0.696). Cannulation period and attempts are reduced by group 1 to 4 (p<0.01), but the decrease in ERCP specific complications which are associated with cannulation time and the number of attempts was not statistically significant. On the contrary, hemorrhage complication in the syphinchteretomy line was increased from group 1 to group 4. (p=0.014).
DISCUSSION AND CONCLUSION: 240 cases refer to the critical value in terms of complications. Therefore, in difficult procedures and for patient selection, this value (240 cases) should be considered. Since being an expert is a highly individual situation at ERCP, the standard number of case or definitions of experience are likely to be discussed for a longer time.
Corresponding Author: Ozan Andaç Erbil, Türkiye
Manuscript Language: English