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Trainee caseload correlates with ERCP success rates but not with procedure-related complications: results from a prospective study (the QUASIE cohort)

Authors :
Theodor Voiosu
Andreea Bengus
Andrei Voiosu
Mihai Rimbas
Alina Zlate
Andrei Haidar
Cristian Baicus
Bogdan Mateescu
Source :
Endoscopy International Open, Vol 04, Iss 04, Pp E409-E414 (2016)
Publication Year :
2016
Publisher :
Georg Thieme Verlag KG, 2016.

Abstract

Background and study aim: Endoscopy society guidelines recommend a minimum of 200 cases for endoscopic retrograde cholangiopancreatography (ERCP) trainees in order to ensure competency and quality standards. However, there are few data regarding procedure-related complication rates and added risk for patients during this learning process. We aimed to evaluate the correlation between trainee caseload and procedure- and patient-related outcomes in an ERCP training program, and to assess the risk factors for ERCP failure and complications. Patients and methods: We conducted a prospective study of all procedures performed in the ERCP training program at Colentina Clinical Hospital, Bucharest, Romania. Relevant data for each procedure (diagnosis, cannulation method, outcome, and complications during the following 30 days) as well as operator experience were documented. Univariable and multivariable analysis of the risk factors for ERCP failure and complications was done by analyzing the procedures completed by expert and trainee endoscopists during the study period. Results: The analysis included 534 ERCPs performed by 1 expert and 3 supervised trainees during a 12-month period. Technical success rates were comparable in the trainee and expert groups, and no statistically significant difference was found between the two groups with regard to procedure-related complications and mortality. The more experienced trainees had a better chance of successfully completing a procedure (odds ratio of 1.1 for each additional 10 ERCPs performed), but post-ERCP complications were unrelated to individual trainee caseloads on multivariable analysis. Conclusion: The ERCP technical success rate increases with trainee experience, reflecting the learning curve of individual operators. However, the complication rates are similar across different levels of operator experience, indicating that ERCPs performed by supervised trainees imply no additional risk for patients.

Details

Language :
English
ISSN :
23643722, 21969736, 00421022, and 24364657
Volume :
04
Issue :
04
Database :
Directory of Open Access Journals
Journal :
Endoscopy International Open
Publication Type :
Academic Journal
Accession number :
edsdoj.44212b8b243646578431e87c8584ae77
Document Type :
article
Full Text :
https://doi.org/10.1055/s-0042-102248