PDF herunterladen
Endoscopy
DOI: 10.1055/a-2619-8434
Position Statement

Quality standards and curriculum for training in cholangiopancreatoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Gavin Johnson
 1   Pancreaticobiliary Unit, University College London Hospital, London, UK
 2   Cleveland Clinic, London, UK
,
George Webster
 1   Pancreaticobiliary Unit, University College London Hospital, London, UK
,
Apostolis Papaefthymiou 
 1   Pancreaticobiliary Unit, University College London Hospital, London, UK
 2   Cleveland Clinic, London, UK
,
Sara Teles de Campos
 3   Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Hôpital Universitaire de Bruxelles, Brussels, Belgium
,
László Czakó
 4   Center for Gastroenterology, Department of Medicine, University of Szeged, Szeged, Hungary
,
Christoph Schlag
 5   Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
,
Marcus Hollenbach 
 6   Department of Gastroenterology, Endocrinology, Infectious Diseases, University of Giessen and Marburg UKGM, Giessen, Germany
,
Andrea Anderloni
 7   Gastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy
,
Wafaa Ahmed 
 8   Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
,
Ivo Boskoski 
 9   Digestive Endoscopy Unit, Fondazione IRCCS Policlinico Universitario Agostino Gemelli, Rome, Italy
,
Mark Ellrichmann 
10   Interdisciplinary Endoscopy, Medical Department 1, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
,
Paraskevas Gkolfakis 
11   Department of Gastroenterology, Konstantopouleio-Patision General Hospital, Athens, Greece
,
István Hritz
12   Department of Surgery, Transplantation and Gastroenterology, Division of Interventional Gastroenterology, Semmelweis University, Budapest, Hungary
,
Tomáš Hucl
13   Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
,
Leena Kylänpää
14   Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland
,
Mauro Manno
15   Gastroenterology and Digestive Endoscopy Unit, Azienda USL di Modena, Carpi Hospital, Modena, Italy
,
Jan Werner Poley
16   Department of Gastroenterology and Hepatology, Maastricht UMC+, Maastricht, The Netherlands
,
Juan J. Vila 
17   Endoscopy Unit, Gastroenterology Department, Hospital Universitario de Navarra IdiSNA, Navarra, Spain
18   Institute for Health Research, Pamplona, Spain
,
Tony C. Tham 
19   Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland
,
Monika Ferlitsch
20   Department of Internal Medicine with Gastroenterology and Geriatrics, Klinik Floridsdorf, Vienna, Austria
21   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, Austria
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints

Main statements

Quality standards Competence in cholangioscopy should be defined as the ability to successfully perform the procedure effectively, without trainer assistance, in 80 % of procedures. Cholangioscopy should be performed in endoscopy units with a high yearly volume of endoscopic retrograde cholangiopancreatographies (ERCPs) of all grades of complexity.

Cholangiopancreatoscopy practice should be considered as standard or advanced as follows:

− Standard Cholangioscopy for extrahepatic biliary stones; evaluation of extrahepatic biliary strictures; selective ductal guidewire cannulation and removal of migrated biliary stents/foreign body extraction

− Advanced Cholangioscopy for intrahepatic biliary strictures or complex hepatolithiasis; percutaneous cholangioscopy and pancreatoscopy.

Endoscopy units undertaking standard cholangioscopy should have prompt access to the following (on site or within a defined rapidly responsive network):

− Endoscopic ultrasound (EUS)

− Interventional radiology (on-site) and hepaticopancreaticobiliary (HPB) surgery

− HPB multidisciplinary meetings (MDMs).

Complete extrahepatic stone clearance at the initial cholangioscopy session should be successful in 80 % of intention-to-treat cases.

Cholangioscopy is recommended with visually guided biopsies in the evaluation of undefined biliary strictures, ideally at index ERCP to prevent negative visual and histological effects of prior stenting; except in cases with an associated mass lesion that may allow tissue acquisition by other means (e. g. EUS or percutaneous biopsy).

In cholangioscopic evaluation of extrahepatic biliary strictures, visual assessment should be achieved in > 90 % of cases, and at least 4 visually guided biopsies should be undertaken with sufficient tissue for histological assessment being obtained in > 80 % of cases.

Percutaneous transhepatic cholangioscopy is indicated in patients with transhepatic bile duct access in cases of altered anatomy or failed ERCP and an indication for cholangioscopy (stone management; biliary stricture evaluation; foreign body removal).

Curriculum for training Cholangioscopy is considered an advanced adjunct to ERCP, and prior to undertaking supervised cholangioscopic procedures trainees should be competent in the basic skills of ERCP (Schutz level 1 and 2) as defined by ESGE (duodenal intubation; biliary cannulation; distal bile duct stenting; ≤ 10-mm stone extraction).

Cholangioscopy training should take place in expert referral centers with a high volume of ERCP and cholangioscopy cases.

A trainee’s principal trainer should be an experienced trainer ideally with at least 3 years of experience in undertaking independent cholangioscopy to the determined quality standards.

Competence in cholangioscopy should be defined as the ability to successfully perform the procedure effectively without trainer assistance in 80 % of procedures.



Publikationsverlauf

Artikel online veröffentlicht:
30. Juni 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Ponchon T, Genin G, Mitchell R. et al. Methods, indications, and results of percutaneous choledochoscopy. A series of 161 procedures Surg 1996; 223: 26-36
    Suche in Google Scholar
  • 2 Urakami Y, Seifert E, Butke H. Peroral direct cholangioscopy (PDCS) using routine straight-view endoscope: first report. Endoscopy 1977; 9: 27-30
    Suche in Google Scholar
  • 3 Chen YK. Preclinical characterization of the Spyglass peroral cholangiopancreatoscopy system for direct access, visualization, and biopsy. Gastrointest Endosc 2007; 65: 303-311
    Suche in Google Scholar
  • 4 Stassen PMC, de Jonge PJF, Webster GJM. et al. Clinical practice patterns in indirect peroral cholangiopancreatoscopy: outcome of a European survey. Endosc Int Open 2021; 9: E1704-E1711
    Suche in Google Scholar
  • 5 Rutter MD, Senore C, Bisschops R. et al. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: Developing performance measures. Endoscopy 2016; 48: 81-89
    Suche in Google Scholar
  • 6 Bisschops R, Dekker E, East JE. et al. European Society of Gastrointestinal Endoscopy (ESGE) curricula development for postgraduate training in advanced endoscopic procedures: rationale and methodology. Endoscopy 2019; 51: 976-979
    Suche in Google Scholar
  • 7 Guyatt GH, Oxman AD, Vist GE. et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008; 336: 924-926
    Suche in Google Scholar
  • 8 Nakajima M, Akasaka Y, Yamaguchi K. et al. Direct endoscopic visualization of the bile and pancreatic duct systems by peroral cholangiopancreatoscopy (PCPS). Gastrointest Endosc 1978; 24: 141-145
    Suche in Google Scholar
  • 9 Chen YK, Parsi MA, Binmoeller KF. et al. Single-operator cholangioscopy in patients requiring evaluation of bile duct disease or therapy of biliary stones (with videos). Gastrointest Endosc 2011; 74: 805-814
    Suche in Google Scholar
  • 10 Chathadi KV, Chen YK. New kid on the block: development of a partially disposable system for cholangioscopy. Gastrointest Endosc Clin N Am 2009; 19: 545-555
    Suche in Google Scholar
  • 11 Draganov PV, Lin T, Chauhan S. et al. Prospective evaluation of the clinical utility of ERCP-guided cholangiopancreatoscopy with a new direct visualization system. Gastrointest Endosc 2011; 73: 971-979
    Suche in Google Scholar
  • 12 Soda K, Shitou K, Yoshida Y. et al. Peroral cholangioscopy using new fine-caliber flexible scope for detailed examination without papillotomy. Gastrointest Endosc 1996; 43: 233-238
    Suche in Google Scholar
  • 13 Albert JG, Friedrich-Rust M, Elhendawy M. et al. Peroral cholangioscopy for diagnosis and therapy of biliary tract disease using an ultra-slim gastroscope. Endoscopy 2011; 43: 1004-1009
    Suche in Google Scholar
  • 14 Larghi A, Waxman I. Endoscopic direct cholangioscopy by using an ultra-slim upper endoscope: a feasibility study. Gastrointest Endosc 2006; 63: 853-857
    Suche in Google Scholar
  • 15 Weigt J, Kandulski A, Malfertheiner P. Direct peroral cholangioscopy using ultraslim gastroscopes: high technical performance with important diagnostic yield. Gastrointest Endosc 2014; 79: 173-177
    Suche in Google Scholar
  • 16 Komanduri S, Thosani N, Abu Dayyeh BK. et al. Cholangiopancreatoscopy. Gastrointest Endosc 2016; 84: 209-221
    Suche in Google Scholar
  • 17 Teles de Campos S, Papaefthymiou A, Florou T. et al. Impact of center and endoscopist ERCP volume on ERCP outcomes: a systematic review and meta-analysis. Gastrointest Endosc 2023; 98: 306-315.e14
    Suche in Google Scholar
  • 18 Cotton PB, Eisen G, Romagnuolo J. et al. Grading the complexity of endoscopic procedures: results of an ASGE working party. Gastrointest Endosc 2011; 73: 868-874
    Suche in Google Scholar
  • 19 Olsson G, Arnelo U, Swahn F. et al. The H.O.U.S.E. classification: a novel endoscopic retrograde cholangiopancreatography (ERCP) complexity grading scale.. BMC Gastroenterol 2017; 17: 38
    Suche in Google Scholar
  • 20 Everett S, Ahmed W, Dobson C. British Society of Gastroenterology endoscopic retrograde cholangiopancreatography (ERCP) Quality Improvement Programme: minimum service standards and good practice statement. Frontline Gastroenterol 2024; 15: 445-471
    Suche in Google Scholar
  • 21 Ekkelenkamp VE, de Man RA, Ter Borg F. et al. Prospective evaluation of ERCP performance: results of a nationwide quality registry. Endoscopy 2015; 47: 503-507
    Suche in Google Scholar
  • 22 Vila JJ, Arrubla Gamboa A, Jusué V. et al. The volume of ERCP per endoscopist is associated with a higher technical success and a lower post-ERCP pancreatitis rate. A prospective analysis. Rev Esp Enferm Dig 2023; 115: 368-373
    Suche in Google Scholar
  • 23 Valori R, Cortas G, de Lange T. et al. Performance measures for endoscopy services: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2018; 50: 1186-1204
    Suche in Google Scholar
  • 24 Domagk D, Oppong KW, Aabakken L. et al. Performance measures for ERCP and endoscopic ultrasound: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2018; 50: 1116-1127
    Suche in Google Scholar
  • 25 Joshi D, Paranandi B, El Sayed G. et al. Experience of propofol sedation in a UK ERCP practice: lessons for service provision. Frontline Gastroenterol 2015; 6: 32-37
    Suche in Google Scholar
  • 26 Kalaitzakis E, Webster GJ, Oppong KW. et al. Diagnostic and therapeutic utility of single-operator peroral cholangioscopy for indeterminate biliary lesions and bile duct stones. Eur J Gastroenterol Hepatol 2012; 24: 656-664
    Suche in Google Scholar
  • 27 Veitch AM, Radaelli F, Alikhan R. et al. Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update. Endoscopy 2021; 53: 947-969
    Suche in Google Scholar
  • 28 Fugazza A, Colombo M, Kahaleh M. et al. The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope: A multicenter retrospective international study. Hepatobiliary Pancreat Dis Int 2024; 23: 71-76
    Suche in Google Scholar
  • 29 Uribe Rivera AK, Seeliger B, Saldivar CA. et al. Percutaneous transhepatic cholangioscopy for benign and malignant biliary disease using a novel short single operator cholangioscope. Surg Endosc 2023; 37: 7774-7783
    Suche in Google Scholar
  • 30 Brewer Gutierrez OI, Godoy Brewer G, Zulli C. et al. Multicenter experience with digital single-operator cholangioscopy in pregnant patients. Endosc Int Open 2021; 9: E116-E121
    Suche in Google Scholar
  • 31 Gerges C, Pullmann D, Bahin F. et al. SpyGlass DS-guided lithotripsy for pancreatic duct stones in symptomatic treatment-refractory chronic calcifying pancreatitis. Endosc Int Open 2019; 7: E99-E103
    Suche in Google Scholar
  • 32 Brewer Gutierrez OI, Raijman I, Shah RJ. et al. Safety and efficacy of digital single-operator pancreatoscopy for obstructing pancreatic ductal stones. Endosc Int Open 2019; 7: E896-E903
    Suche in Google Scholar
  • 33 Lenze F, Bokemeyer A. et al. Safety, diagnostic accuracy and therapeutic efficacy of digital single-operator cholangioscopy. United Eur Gastroenterol J 2018; 6: 902-909
    Suche in Google Scholar
  • 34 Woo YS, Lee JK, Oh SH. et al. Role of SpyGlass peroral cholangioscopy in the evaluation of indeterminate biliary lesions. Dig Dis Sci 2014; 59: 2565-70
    Suche in Google Scholar
  • 35 Farnik H, Weigt J, Malfertheiner P. et al. A multicenter study on the role of direct retrograde cholangioscopy in patients with inconclusive endoscopic retrograde cholangiography. Endoscopy 2014; 46: 16-21
    Suche in Google Scholar
  • 36 Dumonceau JM, Kapral C, Aabakken L. et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2020; 52: 127-149
    Suche in Google Scholar
  • 37 Sethi A, Chen YK, Austin GL. et al. ERCP with cholangiopancreatoscopy may be associated with higher rates of complications than ERCP alone: a single-center experience. Gastrointest Endosc 2011; 73: 251-256
    Suche in Google Scholar
  • 38 Bernica J, Elhanafi S, Kalakota N. et al. Cholangioscopy is safe and feasible in elderly patients. Clin Gastroenterol Hepatol 2018; 16: 1293-1299.e2
    Suche in Google Scholar
  • 39 Minami H, Mukai S, Sofuni A. et al. Clinical outcomes of digital cholangioscopyguided procedures for the diagnosis of biliary strictures and treatment of difficult bile duct stones: a single-center large cohort study. J Clin Med 2021; 10: 1638
    Suche in Google Scholar
  • 40 Manes G, Paspatis G, Aabakken L. et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2019; 51: 472-491
    Suche in Google Scholar
  • 41 Aljebreen AM, Alharbi OR, Azzam N. et al. Efficacy of spyglass-guided electrohydraulic lithotripsy in difficult bile duct stones. Saudi J Gastroenterol 2014; 20: 366-370
    Suche in Google Scholar
  • 42 Bhandari S, Bathini R, Sharma A. et al. Usefulness of single-operator cholangioscopy-guided laser lithotripsy in patients with Mirizzi syndrome and cystic duct stones: experience at a tertiary care center. Gastrointest Endosc 2016; 84: 56-61
    Suche in Google Scholar
  • 43 Brewer Gutierrez OI, Bekkali NLH, Raijman I. et al. Efficacy and safety of digital single-operator cholangioscopy for difficult biliary stones. Clin Gastroenterol Hepatol 2018; 16: 918-926.e1
    Suche in Google Scholar
  • 44 Maydeo AP, Rerknimitr R, Lau JY. et al. Cholangioscopy-guided lithotripsy for difficult bile duct stone clearance in a single session of ERCP: results from a large multinational registry demonstrate high success rates. Endoscopy 2019; 51: 922-929
    Suche in Google Scholar
  • 45 Canena J, Lopes L, Fernandes J. et al. Outcomes of single-operator cholangioscopy-guided lithotripsy in patients with difficult biliary and pancreatic stones. GE Port J Gastroenterol 2019; 26: 105-113
    Suche in Google Scholar
  • 46 Yan S, Tejaswi S. Clinical impact of digital cholangioscopy in management of indeterminate biliary strictures and complex biliary stones: a single-center study. Ther Adv Gastrointest Endosc 2019; 12
    Suche in Google Scholar
  • 47 Bang JY, Sutton B, Navaneethan U. et al. Efficacy of singleoperator cholangioscopy-guided lithotripsy compared with large balloon sphincteroplasty in management of difficult bile duct stones in a randomized trial. Clin Gastroenterol Hepatol 2020; 18: 2349-2356.e3
    Suche in Google Scholar
  • 48 Alrajhi S, Barkun A, Adam V. et al. Early cholangioscopy-assisted electrohydraulic lithotripsy in difficult biliary stones is cost-effective. Therap Adv Gastroenterol 2021; 14
    Suche in Google Scholar
  • 49 Fugazza A, Gabbiadini R, Tringali A. et al. Digital single-operator cholangioscopy in diagnostic and therapeutic bilio-pancreatic diseases: A prospective, multicenter study. Dig Liver Dis 2022; 54: 1243-1249
    Suche in Google Scholar
  • 50 Angsuwatcharakon P, Kulpatcharapong S, Ridtitid W. et al. Digital cholangioscopy-guided laser versus mechanical lithotripsy for large bile duct stone removal after failed papillary large-balloon dilation: a randomized study. Endoscopy 2019; 51: 1066-1073
    Suche in Google Scholar
  • 51 Sejpal DV, Trindade AJ, Lee C. et al. Digital cholangioscopy can detect residual biliary stones missed by occlusion cholangiogram in ERCP: a prospective tandem study. Endosc Int Open 2019; 7: E608-E614
    Suche in Google Scholar
  • 52 Anderloni A, Auriemma F, Fugazza A. et al. Direct peroral cholangioscopy in the management of difficult biliary stones: a new tool to confirm common bile duct clearance. Results of a preliminary study.. J Gastrointestin Liver Dis 2019; 28: 8994
    Suche in Google Scholar
  • 53 Amaral AC, Hussain WK, Han S. Cholangioscopy-guided electrohydraulic lithotripsy versus laser lithotripsy for the treatment of choledocholithiasis: a systematic review. Scand J Gastroenterol 2023; 58: 1213-1220
    Suche in Google Scholar
  • 54 Sun X, Zhou Z, Tian J. et al. Is single-operator peroral cholangioscopy a useful tool for the diagnosis of indeterminate biliary lesion? A systematic review and metaanalysis.. Gastrointest Endosc 2015; 82: 79-87
    Suche in Google Scholar
  • 55 Ishii Y, Serikawa M, Tsuboi T. et al. Usefulness of peroral cholangioscopy in the differential diagnosis of IgG4-related sclerosing cholangitis and extrahepatic cholangiocarcinoma: a single-center retrospective study. BMC Gastroenterol 2020; 20: 287
    Suche in Google Scholar
  • 56 Yang D, Wagh MS, Draganov PV. The status of training in new technologies in advanced endoscopy: from defining competence to credentialing and privileging. Gastrointest Endosc 2020; 92: 1016-1025
    Suche in Google Scholar
  • 57 Almadi MA, Itoi T, Moon JH. et al. Using single-operator cholangioscopy for endoscopic evaluation of indeterminate biliary strictures: results from a large multinational registry. Endoscopy 2020; 52: 574-582
    Suche in Google Scholar
  • 58 Weigand K, Küchle M, Zuber-Jerger I. et al. Diagnostic accuracy and therapeutic efficacy of digital single-operator cholangioscopy for biliary lesions and stenosis. Digestion 2021; 102: 776-782
    Suche in Google Scholar
  • 59 Stassen PMC, Goodchild G, de Jonge PJF. et al. Diagnostic accuracy and interobserver agreement of digital single-operator cholangioscopy for indeterminate biliary strictures. Gastrointest Endosc 2021; 94: 1059-1068
    Suche in Google Scholar
  • 60 Sethi A, Tyberg A, Slivka A. et al. Digital single-operator cholangioscopy (DSOC) improves interobserver agreement (IOA) and accuracy for evaluation of indeterminate biliary strictures: the Monaco classification. J Clin Gastroenterol 2022; 56: e94-e97
    Suche in Google Scholar
  • 61 Kahaleh M, Raijman I, Gaidhane M. et al. Digital cholangioscopic interpretation: when north meets the south. Dig Dis Sci 2022; 67: 1345-1351
    Suche in Google Scholar
  • 62 Crinò SF, Conti BellocchiMC, Antonini F. et al. Impact of biliary stents on the diagnostic accuracy of EUS-guided fine-needle biopsy of solid pancreatic head lesions: A multicenter study. Endosc Ultrasound 2021; 10: 440-447
    Suche in Google Scholar
  • 63 Wen LJ, Chen JH, Xu HJ. et al. Efficacy and safety of digital singleoperator cholangioscopy in the diagnosis of indeterminate biliary strictures by targeted biopsies: a systematic review and meta-analysis. Diagnostics (Basel) 2020; 10
    Suche in Google Scholar
  • 64 Sejpal DV, Vamadevan AS, Trindade AJ. Removal of an embedded, migrated plastic biliary stent with the use of cholangioscopy. Gastrointest Endosc 2015; 81: 1482-1483
    Suche in Google Scholar
  • 65 Tharian B, Canipe A, Navaneethan U. et al. Successful removal of a foreign body from a gallbladder remnant by using a new single operator digital cholangioscope. Gastrointest Endosc 2015; 82: 1125
    Suche in Google Scholar
  • 66 Ogura T, Okuda A, Miyano A. et al. Migrated endoclip removal after cholecystectomy under digital single-operator cholangioscopy guidance. Endoscopy 2018; 50: E74-E75
    Suche in Google Scholar
  • 67 Bas-Cutrina F, Garcia-Sumalla A, Velasquez J. et al. Removal of a migrated biliary stent using new digital cholangioscopy retrieval devices in a transplant patient. Endoscopy 2019; 51: E323-E324
    Suche in Google Scholar
  • 68 Di Mitri R, Mocciaro F, Bonaccorso A. et al. SpyGlass rescue treatment of common bile duct impacted foreign bodies. Dig Liver Dis 2019; 51: 453
    Suche in Google Scholar
  • 69 Maselli R, Troncone E, Fugazza A. et al. Endoscopic retrieval of a proximally migrated biliary plastic stent using direct per-oral cholangioscopy. J Gastrointestin Liver Dis 2019; 28: 8
    Suche in Google Scholar
  • 70 Zhang Y, Feng Y. Radiation-free digital cholangioscopy-guided removal of bile duct foreign body and holmium laser lithotripsy for large common bile duct stones. Endoscopy 2023; 55: E420-E421
    Suche in Google Scholar
  • 71 Boeva I, Karagyozov PI, Tishkov I. Post-liver transplant biliary complications: Current knowledge and therapeutic advances. World J Hepatol 27 2021; 13: 66-79
    Suche in Google Scholar
  • 72 Gazzaniga GM, Faggioni A, Bondanza G. et al. Percutaneous transhepatic cholangioscopy. Int Surg 1983; 68: 357-360
    Suche in Google Scholar
  • 73 Papaefthymiou A, Gkolfakis P, Basiliya K. et al. Performance and safety of percutaneous cholangioscopy: a systematic review and meta-analysis. Ann Gastroenterol 2024; 37: 225-234
    Suche in Google Scholar
  • 74 Tao H, Wang P, Sun B. et al. One-step percutaneous transhepatic cholangioscopy combined with high-frequency needle-knife electrotomy in biliary strictures after liver transplantation. Surg Laparosc Endosc Percutan Tech 2021; 31: 787-793
    Suche in Google Scholar
  • 75 Arnelo U, Siiki A, Swahn F. et al. Single-operator pancreatoscopy is helpful in the evaluation of suspected intraductal papillary mucinous neoplasms (IPMN). Pancreatology 2014; 14: 510-514
    Suche in Google Scholar
  • 76 Dumonceau JM, Delhaye M, Tringali A. et al. Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Updated August 2018. Endoscopy 2019; 51: 179-193
    Suche in Google Scholar
  • 77 Löhr JM, Dominguez-Munoz E. et al. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). United European Gastroenterol J 2017; 5: 153-199
    Suche in Google Scholar
  • 78 Gerges C, Albers D, Schmitz L. et al. Digital single-operator pancreatoscopy for the treatment of symptomatic pancreatic duct stones: a prospective multicenter cohort trial. Endoscopy 2023; 55: 150-157
    Suche in Google Scholar
  • 79 van der Wiel SE, Stassen PMC, Poley JW. et al. Pancreatoscopy-guided electrohydraulic lithotripsy for the treatment of obstructive pancreatic duct stones: a prospective consecutive case series. Gastrointest Endosc 2022; 95: 905-914.e2
    Suche in Google Scholar
  • 80 de Rijk FEM, Stassen PMC, van der Wiel SE. et al. Long-term outcomes of pancreatoscopy-guided electrohydraulic lithotripsy for the treatment of obstructive pancreatic duct stones. Endosc Int Open 2023; 11: E296-E304
    Suche in Google Scholar
  • 81 Han S, Miley A, Akshintala V. et al. Peroral pancreatoscopy-guided lithotripsy vs. extracorporeal shock wave lithotripsy for treating refractory main pancreatic duct stones in chronic pancreatitis: Protocol for an open-label multi-center randomized clinical trial. Pancreatology 2022; 22: 1120-1125
    Suche in Google Scholar
  • 82 Maydeo A, Kwek A, Bhandari S. et al. SpyGlass pancreatoscopyguided cannulation and retrieval of a deeply migrated pancreatic duct stent. Endoscopy 2011; 43 (Suppl. 02) E137-E138
    Suche in Google Scholar
  • 83 Bhandari S, Sharma A, Bathini R. et al. Endoscopic management of internally migrated pancreatic duct stents (with video). Indian J Gastroenterol 2016; 35: 91-100
    Suche in Google Scholar
  • 84 Asif S, Kalpala R, Reddy DN. Peroral pancreatoscopy-assisted removal of internally migrated fractured pancreatic stent. Endoscopy 2020; 52: E359
    Suche in Google Scholar
  • 85 Gomes C, Pinho R, Proença L. et al. Endoscopic retrieval of a proximally migrated pancreatic stent through spyglass pancreatoscopy. Clin Res Hepatol Gastroenterol 2021; 45: 101707
    Suche in Google Scholar
  • 86 Al-Shahrani AA, Swei E, Wani S. et al. Pancreatoscopy-guided retrieval of a migrated pancreatic duct stent. VideoGIE 2022; 7: 417-418
    Suche in Google Scholar
  • 87 Tanaka M, Fernández-Del Castillo C, Kamisawa T. et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology 2017; 17: 738-753
    Suche in Google Scholar
  • 88 de Jong DM, Stassen PMC, Groot Koerkamp B. et al. The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis. Endoscopy 2023; 55: 25-35
    Suche in Google Scholar
  • 89 Jung M, Zipf A, Schoonbroodt D. et al. Is pancreatoscopy of any benefit in clarifying the diagnosis of pancreatic duct lesions?. Endoscopy 1998; 30: 273-280
    Suche in Google Scholar
  • 90 Johnson G, Webster G, Boškoski I. et al. Curriculum for ERCP and endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2021; 53: 1071-1087
    Suche in Google Scholar
  • 91 Wani S, Keswani R, Hall M. et al. A prospective multicenter study evaluating learning curves and competence in endoscopic ultrasound and endoscopic retrograde cholangiopancreatography among advanced endoscopy trainees: The Rapid Assessment of Trainee Endoscopy Skills Study. Clin Gastroenterol Hepatol 2017; 15: 1758-1767.e11
    Suche in Google Scholar
  • 92 Siau K, Dunckley P, Feeney M. et al. ERCP assessment tool: evidence of validity and competency development during training. Endoscopy 2019; 51: 1017-1026
    Suche in Google Scholar
  • 93 Ward ST, Mohammed MA, Walt R. et al. An analysis of the learning curve to achieve competency at colonoscopy using the JETS database. Gut 2014; 63: 1746-1754
    Suche in Google Scholar
  • 94 Lim BS, Leung JW, Lee J. et al. Effect of ERCP mechanical simulator (EMS) practice on trainees’ ERCP performance in the early learning period: US multicenter randomized controlled trial. Am J Gastroenterol 2011; 106: 300-306
    Suche in Google Scholar
  • 95 Liao WC, Leung JW, Wang HP. et al. Coached practice using ERCP mechanical simulator improves trainees’ ERCP performance: a randomized controlled trial. Endoscopy 2013; 45: 799-805
    Suche in Google Scholar
  • 96 Ekkelenkamp VE, Koch AD, Rauws EA. et al. Competence development in ERCP: the learning curve of novice trainees. Endoscopy 2014; 46: 949-955
    Suche in Google Scholar
  • 97 James TW, Baron TH. Practical applications and learning curve for EUS-guided hepaticoenterostomy: results of a large single-center US retrospective analysis. Endosc Int Open 2019; 7: E600-E607
    Suche in Google Scholar
  • 98 Teoh AY, Perez-Miranda M, Kunda R. et al. Outcomes of an international multicenter registry on EUS-guided gallbladder drainage in patients at high risk for cholecystectomy. Endosc Int Open 2019; 7: E964-E973
    Suche in Google Scholar
  • 99 Oh D, Park DH, Song TJ. et al. Optimal biliary access point and learning curve for endoscopic ultrasound-guided hepaticogastrostomy with transmural stenting. Therap Adv Gastroenterol 2017; 10: 42-53
    Suche in Google Scholar
  • 100 Robles-Medranda C, Baquerizo-Burgos J, Alcivar-Vasquez J. et al. Artificial intelligence for diagnosing neoplasia on digital cholangioscopy: development and multicenter validation of a convolutional neural network model. Endoscopy 2023; 55: 719-727
    Suche in Google Scholar
  • 101 Hassan C, Ponchon T, Bisschops R. et al. European Society of Gastrointestinal Endoscopy (ESGE) publications policy – Update 2020. Endoscopy 2020; 52: 123-126
    Suche in Google Scholar