How do we ensure that trainees learn to perform biliary sphincterotomy safely, appropriately, and effectively?

@article{Leung2008HowDW,
  title={How do we ensure that trainees learn to perform biliary sphincterotomy safely, appropriately, and effectively?},
  author={Joseph W. C. Leung and Erina N. Foster},
  journal={Current Gastroenterology Reports},
  year={2008},
  volume={10},
  pages={163-168}
}
Sphincterotomy is a high-risk procedure with considerable complications. Trainees should learn and understand the basics of endoscopic retrograde cholangiopancreatography and sphincterotomy to ensure good clinical outcomes. Teaching of sphincterotomy usually involves supervised hands-on clinical practice with patients. Proper positioning of the endoscope allows for correct orientation with the papilla, and performing the cut along the “ideal” biliary axis optimizes results and reduces… 
The Role of Sphincterotomy on the Outcome of Post Endoscopic Retrograde Cholangiopancreatography Pancreatites
TLDR
Sphincterotomy can be performed safely and effectively during ERCP without fear of an increased risk of post-ERCP pancreatitis.
Partially covered vs uncovered sphincterotome and post-endoscopic sphincterotomy bleeding.
TLDR
The partially covered sphincterotome was not associated with a lower frequency of bleeding and there was no difference in the incidence and pattern of visible bleeding rates between the 2 groups.
Training in Endoscopic Retrograde Cholangiopancreatography
TLDR
The current paradigm focuses on case volume, but a more comprehensive and qualitative approach to assessment of competency may and should be a part of the future of ERCP training.
ERCP training - the potential role of simulation practice.
TLDR
Whether simulation practice will impact trainee performance and clinical outcome of ERCP procedures will require prospective evaluation with randomized controlled studies.
Endoscopic electrosurgery an overview
TLDR
An overview of electrosurgery, its uses, and risk management and safety issues is provided.
Le traitement endoscopique de la lithiase de la voie biliaire principale ( A propos de 252 cas )
JURY M. Professeur M. Professeur . KHATOUF MOHAMMED Professeur M. MAZAZ KHALID Professeur M. BENAJAH DAFR-ALLAH Professeur M. BENADDIA LAHBIB ...... BENKIRANE
Simulators in anaesthesia and healthcare
TLDR
Simulation and simulation techniques help improve the quality of care in the anesthesiology practice and provide real-time information on how to care for patients with complex medical conditions.

References

SHOWING 1-10 OF 28 REFERENCES
Wire-guided sphincterotomy.
TLDR
In vitro data suggest that significant capacitive coupling currents (or short circuits) may occur on the standard Teflon-coated guidewire when used with a double lumen sphincterotome, resulting in electrosurgical burns.
An assessment of the learning curve for precut biliary sphincterotomy
WHICH MODALITY CAN BE STANDARDERIZED for ENDOSCOPIC SPHINCTEROTOMY in JAPAN?
TLDR
The modality employing Clever Cut3 and a high‐frequency surgical apparatus equipped with an insulated guide‐wire and the Endocut system may be considered standard ES in Japan.
Complications of endoscopic biliary sphincterotomy.
TLDR
The rate of complications after endoscopic biliary sphincterotomy can vary widely in different circumstances and is primarily related to the indication for the procedure and to endoscopic technique, rather than to the age or general medical condition of the patients.
Quantitative Assessment of Procedural Competence: A Prospective Study of Training in Endoscopic Retrograde Cholangiopancreatography
TLDR
The learning curve for ERCP was studied by prospectively evaluating gastroenterology fellows at a tertiary medical center by determining the percentage of the total time of the ERCPs that was done by the fellow.
The impact of a hands-on ERCP workshop on clinical practice.
...
1
2
3
...