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Patient‐related factors associated with successful cannulation by trainees during hands‐on endoscopic retrograde cholangiopancreatography training
Author(s) -
Zheng Liang,
Wang Limei,
Ren Gui,
Zhang Rongchun,
Liang Shuhui,
Wang Biaoluo,
Zhang Linhui,
Wang Xiangping,
Luo Bing,
Pan Yanglin,
Guo Xuegang
Publication year - 2019
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13377
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , general surgery , training (meteorology) , surgery , pancreatitis , physics , meteorology
Background and Aim Hands‐on endoscopic retrograde cholangiopancreatography ( ERCP ) training is essential for trainees to grasp the technique. Cannulation success rate ( CSR ) is considered one of the main indicators of competency of trainees. We aimed to investigate whether patient‐related factors had an impact on the CSR of trainees. Methods A post hoc analysis of data from two multicenter studies ( NCT 02002650 and NCT 03057769) was conducted. Patients aged 18–90 years with native papilla undergoing ERCP were eligible for this study. Only procedures involving trainees in centers strictly following “10‐min criteria” for initial cannulation were enrolled. Primary outcome was CSR by trainees. Results From December 2013 to October 2017, 20 trainees in four centers were involved in initial cannulation in 1044 patients with native papilla. Primary CSR by trainees was 61.0% (436/715), 31.5% (70/222) and 44.9% (48/107) in patients with common bile duct stone ( CBDS ), biliary stricture ( BS ) and other indications, respectively ( P < 0.001). In multivariate analysis, indication of BS ( OR , 0.31; 95% CI , 0.22–0.44; P < 0.001) and presence of type A diverticulum ( OR , 1.69; 95% CI , 1.23–2.33; P = 0.001) were both independently associated with cannulation success of trainees. Biliary infection was significantly higher in the BS than in the CBDS group (3.6% vs 0.7%, P = 0.004), whereas other post‐ ERCP complications were comparable between the two groups. Conclusions Indication of BS and the presence of type A diverticulum were independently associated with the success of cannulation by trainees. These findings indicate that greater effort is needed for trainees to improve the ability of cannulation in BS .