title: How safe and successful are live demonstrations of therapeutic ERCP? A large multicenter study.
abstract: OBJECTIVE
  Live demonstrations of endoscopic retrograde cholangiopancreatography (ERCP) have a high educational value and contribute significantly to endoscopy development and training. However, the success and safety of live demonstration have been questioned. The aim of this study was to evaluate the success rate and complications of therapeutic ERCP among patients who participated in live demonstrations.
  
  
  METHODS
  Patients who underwent therapeutic ERCP during live demonstrations at gastrointestinal endoscopy conferences in China between January 2002 and December 2007 were included. The matched control for each patient was a patient admitted to the same ERCP unit with similar indication, who received ERCP by an endoscopist with similar experience as those who performed the live demonstration. Patient's age, gender, indication, success rate, and complications of ERCP were collected and compared. ERCP outcomes between local and visiting faculty were also compared.
  
  
  RESULTS
  In total, 36 conferences with live ERCP demonstrations involving 406 patients were held in 14 endoscopy centers. There were no significant differences in patients' gender, age, and indications between live demonstrations and controls. The overall complication rate of ERCP in live demonstrations was not significantly different compared with controls (10.3% vs. 8.6%, P=0.473). However, the success rate was significantly lower in live demonstrations than in controls (94.1% vs. 97.5%, P=0.021). The success and complication rates of ERCP performed by local faculty, domestic visiting, and foreign visiting faculties were similar.
  
  
  CONCLUSIONS
  Although the success rate of therapeutic ERCP performed during live demonstrations was lower than that of routine procedures, the overall complication rate did not significantly increase. ERCP performed by visiting endoscopists was as safe as that done by local faculty in live demonstrations.
authors.affiliation: Department of Gastroenterology, Changhai Hospital, 2nd Military Medical University, 168 Changhai Road, Shanghai, China.
authors.forename: Zhuan
authors.initials: Z
authors.lastname: Liao
authors.forename: Zhao-Shen
authors.initials: ZS
authors.lastname: Li
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Leung
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhang
authors.forename: Shu-Tian
authors.initials: ST
authors.lastname: Zhang
authors.forename: Ming
authors.initials: M
authors.lastname: Ji
authors.forename: Zhi-Ning
authors.initials: ZN
authors.lastname: Fan
authors.forename: Fa-Chao
authors.initials: FC
authors.lastname: Zhi
authors.forename: You-Ming
authors.initials: YM
authors.lastname: Li
authors.forename: Xiao-Xing
authors.initials: XX
authors.lastname: Chen
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.forename: Xu
authors.initials: X
authors.lastname: Ren
authors.forename: Guo-Fa
authors.initials: GF
authors.lastname: Jia
authors.forename: Liu-Ye
authors.initials: LY
authors.lastname: Huang
authors.forename: Nong-Hua
authors.initials: NH
authors.lastname: Lv
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Xie
authors.forename: Zhi-Zheng
authors.initials: ZZ
authors.lastname: Ge
authors.forename: William S C
authors.initials: WS
authors.lastname: Chao
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D004502:Education, Medical, Continuing; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged