Success rate and complications of ERCP performed during hands-on training courses: a multicenter study in China.
BACKGROUND
Hands-on endoscopy workshops are popular and valuable sources for the continuing medical education of endoscopists. Concerns, however, exist regarding clinical outcomes of procedures performed during hands-on training of ERCP.


OBJECTIVE
We compared the success rates and complications between patients in the hands-on training courses and matched control patients.


METHODS
A retrospective, multicenter study.


METHODS
Seven endoscopy centers in mainland China.


METHODS
All patients who underwent ERCP during hands-on training courses at GI endoscopy conferences in China between January 2002 and December 2006 were included.


METHODS
Clinical and endoscopic characteristics, including age, sex, indication, therapeutic intervention, success rate, and complication, were collected. Differences in ERCP outcomes between domestic and foreign mentors were also compared. Conference, patient, and endoscopist-related variables were analyzed for potential risk factors associated with post-ERCP complications.


RESULTS
Nine conferences with hands-on ERCP training, including 124 patients, were held at 7 endoscopy centers. There were no significant differences in the sex ratio, age, indication, and therapeutic intervention between patients for hands-on training (n = 124) and controls (n = 124). The success rates and overall complication rates were similar between the 2 groups (91.9% vs 92.7%, respectively, P = .811; 12.9% vs 9.7%, respectively, P = .422). Domestic mentors encountered more post-ERCP complications than foreign mentors (18.0% vs 0%, respectively, P = .001). Univariate analyses showed that a large-scale conference (P = .004), first-time mentorship (P = .015), and small case volume for the mentor (P = .015) were significantly associated with post-ERCP complications. Nominal significance in univariate testing was removed when analyzed in a comprehensive multivariate setting.


CONCLUSIONS
A nonrandomized retrospective trial with only 7 centers (9 conferences).


CONCLUSIONS
The success rate and overall complication rate were similar between patients in the hands-on training and those who had routine ERCP procedures. A large-scale conference, first-time mentorship, and small case volume for the mentor may be associated with post-ERCP complications.
Liao
Zhuan
Z
Division of Gastroenterology, Changhai Hospital, 2nd Military Medical University, Shanghai, China.
Li
Zhao-Shen
ZS
Leung
Joseph W
JW
Zou
Xiao-Ping
XP
He
Li-Ping
LP
Jia
Guo-Fa
GF
Huang
Qiang
Q
Ji
Ming
M
Huang
Liu-Ye
LY
Chao
William S C
WS
D002681:China; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D004502:Education, Medical, Continuing; D004724:Endoscopy / Q000193:education; D005260:Female; D006801:Humans; D008297:Male; D008611:Mentors; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome