title: Comparison of accessory performance using a novel ERCP mechanical simulator.
abstract: OBJECTIVE
  There is a paucity of in vitro methods for evaluating ERCP accessories. We hypothesize that the time taken to perform a simulated single stent or multiple stents placement is different for stenting systems with or without the capability of intraductal ductal release (IDR) of the guide wire.
  
  
  METHODS
  We conducted an un-blinded in vitro comparison of ERCP accessories using a mechanical simulator during hands-on ERCP practice workshops. A total of 21 U.S. participants and 20 Chinese participants with various level of ERCP experience took part in the different practice workshops. Accessories with and without the capability of intraductal release of guide wire were compared. Total time required for completing a simulated stenting procedure with single or multiple stents and the respective simulated fluoroscopy time were recorded.
  
  
  RESULTS
  There was no significant difference in the time taken for placement of a single stent using either stenting systems. Stenting system capable of intraductal release of the guide wire required significantly shorter time to complete placement of three stents.
  
  
  CONCLUSIONS
  Using time required to complete a specific task, i. e. biliary stenting, the mechanical simulator permits the performance of different accessories by the same group of operators to be evaluated objectively.
authors.affiliation: Section of Gastroenterology, Sacramento Veterans Affairs Medical Center, Veterans Affairs Northern California Healthcare System, Mather, California 95655, USA. jwleung@ucdavis.edu
authors.forename: J W
authors.initials: JW
authors.lastname: Leung
authors.forename: W
authors.initials: W
authors.lastname: Lee
authors.forename: R
authors.initials: R
authors.lastname: Wilson
authors.forename: B S
authors.initials: BS
authors.lastname: Lim
authors.forename: F W
authors.initials: FW
authors.lastname: Leung
mesh_terms: D001291:Attitude of Health Personnel; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation*; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000628:therapy; D003137:Common Bile Duct Diseases / Q000175:diagnosis / Q000628:therapy; D003479:Curriculum; D004493:Education; D004867:Equipment Design; D005257:Fellowships and Scholarships; D005471:Fluoroscopy / Q000295:instrumentation; D005762:Gastroenterology / Q000193:education; D006801:Humans; D066298:In Vitro Techniques; D008953:Models, Anatomic; D015607:Stents; D011795:Surveys and Questionnaires; D013996:Time and Motion Studies