Trainee involvement in ERCP: safe under close surveillance

Gkolfakis, Paraskevas; Arvanitakis, Marianna

doi:10.1055/a-1089-9163

Cited by 4 publications

(3 citation statements)

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“…The training programme should develop not only technical dexterity but also adequate cognitive and non-endoscopic skills, such as decision making, judgement and team communication, with the main focus being patient-centred care. 10…”

Section: Senior Perspective: Marianna Arvanitakismentioning

confidence: 99%

“…All these arguments reinforce the strategy of selecting a limited number of GI fellows who will be trained in interventional endoscopy. The training programme should develop not only technical dexterity but also adequate cognitive and non‐endoscopic skills, such as decision making, judgement and team communication, with the main focus being patient‐centred care 10 …”

Section: Senior Perspective: Marianna Arvanitakismentioning

confidence: 99%

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Young GI Angle: How to manage complications in interventional endoscopy

Heinrich

Arvanitakis

2020

UEG Journal

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You have managed to get a coveted spot for advanced interventional endoscopy training. Deep down, you know you are ready for this, and that you have the skill, will and dedication. 1 Nevertheless, you are aware that procedures such as endoscopic retrograde cholangiopancreatography (ERCP), therapeutic endoscopic ultrasound (EUS), endoscopic submucosal dissection or third-space endoscopy are a completely different ball game to your regular upper or lower endoscopies with the odd polyp resected. Advanced endoscopic procedures are associated with a higher and wider range of complications, which are operator dependent, as many studies have shown. Indeed, regarding ERCP, a meta-analysis (13 studies, 59,437 patients) found that complications were less frequent with high-volume endoscopists (odds ratio (OR) ¼ 0.7; 95% confidence interval (CI) 0.5-0.8). 2 A more recent multi-centre study (1191 patients) identified less experienced endoscopists (<200 ERCP procedures) as an independent risk factor for post-ERCP acute pancreatitis (OR ¼ 1.63; 95% CI 1.05-2.53). 3 Moreover, trainees in advanced endoscopy might, according to one study, take more risks and therefore experience higher complication rates compared with fellows in their general gastroenterology training. 4,5 You, like every other advanced endoscopist, will inevitably cause serious complications to your patients, not only in the beginning but throughout your whole career. Keep this in mind and learn how to manage complications, not only with your endoscope but, even more importantly, with good patient communication.

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Section: Senior Perspective: Marianna Arvanitakismentioning

confidence: 99%

Section: Senior Perspective: Marianna Arvanitakismentioning

confidence: 99%

Young GI Angle: How to manage complications in interventional endoscopy

Heinrich

Arvanitakis

2020

UEG Journal

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“… 2 Consequently, there is an increasing need for dedicated ERCP/EUS training to develop these specialized competencies, reflecting the growing number of training programs in the United States and Europe. 3 However, we must also consider the potential additional impact of trainee participation in critical outcomes of already risky procedures such as ERCP and EUS, 4 , 5 , 6 , 7 further raising the requirement for high standards of quality in these programs.…”

Section: Introductionmentioning

confidence: 99%

A portrait of Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound training programs in Europe: Current practices and opportunities for improvement

2023

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) and EUS are challenging procedures requiring a high level of expertise to provide effective and safe patient care. Thus, high-quality training is needed to achieve competence. We aimed to evaluate the status of European ERCP/EUS training programs, to evaluate adherence to international recommendations, and to propose possible solutions for future improvements. Methods: A web-based survey was developed and ERCP/EUS experts and trainees across Europe were invited to participate. Results: Forty-one experts (out of 50; 82%) and 30 trainees (out of 70; 42.9%) from 18 countries answered the questionnaire. The training program application process is mainly driven by individual requests (87.8%). All surveyed departments offer combined ERCP/EUS training and the majority have adequate facilities and trainers. Although centers are high-volume and provide long-term fellowships, trainee hands-on exposure is not very high (43% expect to do (or did) 100-150 ERCPs and 69% up to 150 EUSs). A formal curriculum is in place in 53.7% centers, including simulation-training in 27.3%. Competence is assessed in 65.7% of centers, but validated tools are applied in only 33.3%. Conclusions: This survey first provides an overview of ERCP/EUS training programs across Europe. It shows that there is adherence to international guidelines to a certain degree, but several gaps in the application process, use of simulators for training, training curriculum and assessment of performance have been recognized. Overcoming these shortcomings could serve as a basis for further improvement in ERCP/EUS training.

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