Training in endoscopic retrograde cholangio-pancreatography: a critical assessment of the broad scenario of training programs and models

Camilla Gallo, Ivo Boškoski, Maria Valeria Matteo, Beatrice Orlandini, Guido Costamagna

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Endoscopic Retrograde Cholangio-Pancreatography (ERCP) applications are rapidly evolving toward increasingly complex therapeutic approaches alongside with technological innovations. There are no globally agreed indications on the ERCP training path, which often requires too much time and does not always guarantee adequate skills. Areas covered: Frequency and difficulty of execution are the main objective criteria on which to draw up a training program: novel trainees should approach ERCP first through the simplest and most frequent procedures. An extensive use of training models would reduce the patient’s performer-related risks. Amongst a wide variety of models, mechanical simulators have received large approval. In fact, they can be best-suited to each trainee’s learning curve thanks to their precision and safety and by virtue of the unlimited repeatability of their use. However, more solid evidences are still needed. Expert opinion: Hands-on ERCP training should systematically employ mechanical simulators at least in the early stages of the learning process. An implementation of these models through sensors that objectively detect abnormalities in the movements would provide detailed feedbacks and deeper awareness. Simulators might also be useful for expert endoscopists to refine their skills. Rapid prototyping and 3D printing might be the way to create customized training models for successful training programs.

Original languageEnglish
Pages (from-to)675-688
Number of pages14
JournalExpert Review of Gastroenterology and Hepatology
Volume15
Issue number6
DOIs
Publication statusPublished - 2021

Keywords

  • Endoscopic Retrograde Cholangio-Pancreatography
  • learning curves
  • mechanical simulators
  • trainees’ competence
  • training models
  • training programs

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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