Competence development of trainees performing short-type single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy

J Hepatobiliary Pancreat Sci. 2022 Dec;29(12):1316-1326. doi: 10.1002/jhbp.1187. Epub 2022 Jun 6.

Abstract

Objectives: This study aimed to evaluate the trainees' practice and learning curve in short-type single-balloon enteroscopy (short SBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) for patients with surgically altered anatomy (SAA) and determine how to train these trainees.

Methods: The data of short SBE-assisted ERCP procedures between September 2011 and June 2021 were analyzed.

Results: Three trainees and 180 cases were included in the analysis. Each trainee performed 60 cases between April 2016 and June 2021. The trainees' completion rate was 73.9% (95% confidence interval [CI], 66.8-80.1%). Adverse events occurred in 5.0% of cases (95% CI, 2.3-9.3%). The trainee who experienced colonoscopy and ERCP the most achieved better outcomes of enteroscopy success (reaching the target site) and trainee's completion rates than those of the others (P = .03 and .02, respectively). The learning curve for trainee's completion showed a significant improvement after 60 cases (P = .001). Multiple logistic regression analysis indicated that Roux-en-Y reconstruction was the factor affecting trainees' completion failure.

Conclusions: Short SBE-assisted ERCP trainees has a substantial learning curve. If trainees do not have much experience with colonoscopy and ERCP procedures, it may be beneficial for them to start performing short SBE-assisted ERCP procedures on non-Roux-en-Y reconstruction cases.

Keywords: ERCP; learning curve; short single-balloon enteroscopy; single-balloon enteroscopy; surgically altered anatomy.

MeSH terms

  • Anastomosis, Roux-en-Y / adverse effects
  • Cholangiopancreatography, Endoscopic Retrograde* / methods
  • Endoscopy, Gastrointestinal
  • Humans
  • Retrospective Studies
  • Single-Balloon Enteroscopy*