Endosc Int Open 2016; 04(04): E409-E414
DOI: 10.1055/s-0042-102248
Original article
© Georg Thieme Verlag KG Stuttgart · New York

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

Theodor Voiosu
1   Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania
,
Andreea Bengus
1   Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania
,
Andrei Voiosu
1   Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania
,
Mihai Rimbas
1   Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania
,
Alina Zlate
1   Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania
,
Andrei Haidar
1   Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania
,
Cristian Baicus
2   Internal Medicine Department, Colentina Clinical Hospital, Bucharest, Romania
,
Bogdan Mateescu
1   Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania
› Institutsangaben
Weitere Informationen

Publikationsverlauf

submitted 07. Oktober 2015

accepted after revision 19. Januar 2016

Publikationsdatum:
30. März 2016 (online)

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.

 
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