ERCP

ERCP plays an important role in the management of patients with pancreaticobiliary diseases. It is technically challenging and carries substantial risks. Therefore, proper training is important to ensure a good clinical outcome. In order for the trainees to meet the minimum expectation, which may be difficult in some centers due to limited availability of patients, many programs offer ERCP training only to a select few, often times in the form of an additional year of advanced fellowship. For successful ERCP training to occur, certain prerequisites are expected of the trainers and the trainees. During training, the trainee must learn both the cognitive aspect and technical skills of ERCP. The technical skills that trainees must learn include, but are not restricted to, scope handling, selective cannulation, papillotomy, stone extraction, stenting, stricture dilation, brush cytology, and lithotripsy. To create more opportunities for hands-on practice, different simulators are used to supplement clinical ERCP training. To date, there is a lack of objective criteria to truly assess competency in ERCP, but the total number of procedures is used as a surrogate.