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    Increased ERCP Volume Improves Cholangiogram Interpretation - A New Performance Measure for ERCP Training?

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    Author
    Ahmad, Saqib
    Keyword
    Cholangiograms
    Endoscopic retrograde cholangiopancreatography
    Key performance indicators
    Training
    
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    Publisher's URL
    https://www.e-ce.org/journal/view.php?doi=10.5946/ce.2021.239
    Abstract
    Background/aims: Cholangiogram interpretation is not used as a key performance indicator (KPI) of endoscopic retrograde cholangiopancreatography (ERCP) training, and national societies recommend different minimum numbers per annum to maintain competence. This study aimed to determine the relationship between correct ERCP cholangiogram interpretation and experience. Methods: One hundred fifty ERCPists were surveyed to appropriately interpret ERCP cholangiographic findings. There were three groups of 50 participants each: "Trainees," "Consultants Group 1" (performed >75 ERCPs per year), and "Consultants Group 2" (performed >100 ERCPs per year). Results: Trainees was inferior to Consultants Groups 1 and 2 in identifying all findings except choledocholithiasis outside the intrahepatic duct on the initial or completion/occlusion cholangiogram. Consultants Group 1 was inferior to Consultants Group 2 in identifying Strasberg type A bile leaks (odd ratio [OR] 0.86, 95% confidence interval [CI] 0.77-0.96), Strasberg type B (OR 0.84, 95% CI 0.74-0.95), and Bismuth type 2 hilar strictures (OR 0.81, 95% CI 0.69-0.95). Conclusions: This investigation supports the notion that cholangiogram interpretation improves with increased annual ERCP case volumes. Thus, a higher annual volume of procedures performed may improve the ability to correctly interpret particularly difficult findings. Cholangiogram interpretation, in addition to bile duct cannulation, could be considered as another KPI of ERCP training.
    Citation
    Vedantam, S. et al. (2022) ‘Increased ERCP Volume Improves Cholangiogram Interpretation - A New Performance Measure for ERCP Training?’, Clinical endoscopy.
    Publisher
    Clinical Endoscopy
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15190
    Collections
    Gastroenterology and Hepatology Services

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