Evaluating the Feasibility of Direct Peroral Cholangioscopy Training with an Endoscopic Simulator

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2012 Jun 5

PMID 22661276

Citations 2

Authors

Ching-Chung Lin

Chih-Jen Chen

Cheng-Hsin Chu

Chien-Yuan Hung

Ming-Jen Chen

Horng-Yuan Wang

Shou-Chuan Shih

Chia-Yuan Liu

Affiliations

Soon will be listed here.

Abstract

Introduction: Direct peroral cholangioscopy (DPOCS) was reported to present clinical potential, and creating a target-specific training program for biliary endoscopists who lack experience with DPOCS is an important task.

Methods: This prospective and observational study used five male domestic pigs. Optimal procedures were decided after pilot tests using an in vivo live porcine model. A total of three ERCP men were enrolled into the training program. The objective parameters, including the rate of success and complications, and the length of the procedure, were recorded for each participant.

Results: In the training program, all the trainees successfully performed DPOCS and biopsies without significant complications. Close observation, free discussions, and the sharing of experiences helped shorten the total procedure time from 37.3 to 18.5 min.

Conclusions: This training program is a feasible approach to help biliary endoscopists acquire the experience for DPOCS with the ultrathin endoscope.

Citing Articles

Directional movement guide for digital single-operator cholangioscopy system.

Gu W, Tan J, Jin H, Lou Q, Tang C, Cheung K VideoGIE. 2024; 9(12):525-529.

PMID: 39698407 PMC: 11652092. DOI: 10.1016/j.vgie.2024.08.009.

Cholangioscopy under direct visualization: skill progress during a dedicated Image-Guided Surgery Course.

Gimenez M, Uribe Rivera A, Montanelli J, Swanstrom L, Mutter D, Seeliger B Surg Endosc. 2023; 37(10):8116-8122.

PMID: 37658199 DOI: 10.1007/s00464-023-10357-7.

References

Wagh M, Waxman I . Animal models for endoscopic simulation. Gastrointest Endosc Clin N Am. 2006; 16(3):451-6. DOI: 10.1016/j.giec.2006.03.011. View

Itoi T, Sofuni A, Itokawa F, Shinohara Y, Moriyasu F, Tsuchida A . Evaluation of residual bile duct stones by peroral cholangioscopy in comparison with balloon-cholangiography. Dig Endosc. 2010; 22 Suppl 1:S85-9. DOI: 10.1111/j.1443-1661.2010.00954.x. View

Chen Y, Pleskow D . SpyGlass single-operator peroral cholangiopancreatoscopy system for the diagnosis and therapy of bile-duct disorders: a clinical feasibility study (with video). Gastrointest Endosc. 2007; 65(6):832-41. DOI: 10.1016/j.gie.2007.01.025. View

Hochberger J, Euler K, Naegel A, Hahn E, Maiss J . The compact Erlangen Active Simulator for Interventional Endoscopy: a prospective comparison in structured team-training courses on "endoscopic hemostasis" for doctors and nurses to the "Endo-Trainer" model. Scand J Gastroenterol. 2004; 39(9):895-902. DOI: 10.1080/00365520410006765. View

Waxman I, Dillon T, Chmura K, Wardrip C, Chennat J, Konda V . Feasibility of a novel system for intraductal balloon-anchored direct peroral cholangioscopy and endotherapy with an ultraslim endoscope (with videos). Gastrointest Endosc. 2010; 72(5):1052-6. DOI: 10.1016/j.gie.2010.06.048. View

Jowell P, Baillie J, Branch M, Affronti J, Browning C, Bute B . Quantitative assessment of procedural competence. A prospective study of training in endoscopic retrograde cholangiopancreatography. Ann Intern Med. 1996; 125(12):983-9. DOI: 10.7326/0003-4819-125-12-199612150-00009. View

Sedlack R, Petersen B, Binmoeller K, Kolars J . A direct comparison of ERCP teaching models. Gastrointest Endosc. 2003; 57(7):886-90. DOI: 10.1016/s0016-5107(03)70025-x. View

Neumann M, Mayer G, Ell C, Felzmann T, Reingruber B, Horbach T . The Erlangen Endo-Trainer: life-like simulation for diagnostic and interventional endoscopic retrograde cholangiography. Endoscopy. 2000; 32(11):906-10. DOI: 10.1055/s-2000-8090. View

Itoi T, Osanai M, Igarashi Y, Tanaka K, Kida M, Maguchi H . Diagnostic peroral video cholangioscopy is an accurate diagnostic tool for patients with bile duct lesions. Clin Gastroenterol Hepatol. 2010; 8(11):934-8. DOI: 10.1016/j.cgh.2010.06.029. View

10.

Rodriguez S, Banerjee S, Desilets D, Diehl D, Farraye F, Kaul V . Ultrathin endoscopes. Gastrointest Endosc. 2010; 71(6):893-8. DOI: 10.1016/j.gie.2010.01.022. View

11.

Moon J, Ko B, Choi H, Hong S, Cheon Y, Cho Y . Intraductal balloon-guided direct peroral cholangioscopy with an ultraslim upper endoscope (with videos). Gastrointest Endosc. 2009; 70(2):297-302. DOI: 10.1016/j.gie.2008.11.019. View

12.

Sedlack R . Endoscopic simulation: where we have been and where we are going. Gastrointest Endosc. 2005; 61(2):216-8. DOI: 10.1016/s0016-5107(04)02639-2. View

13.

Wang H, Chen J, Wu M, Wang H, Chou A, Chang Y . Application of peroral cholangioscopy in an endemic area with high prevalence of hepatocellular carcinoma and choledocholithiasis. Hepatogastroenterology. 2001; 47(36):1555-9. View

14.

Fukuda Y, Tsuyuguchi T, Sakai Y, Tsuchiya S, Saisyo H . Diagnostic utility of peroral cholangioscopy for various bile-duct lesions. Gastrointest Endosc. 2005; 62(3):374-82. DOI: 10.1016/j.gie.2005.04.032. View

15.

Maple J, Keswani R, Hovis R, Saddedin E, Jonnalagadda S, Azar R . Carbon dioxide insufflation during ERCP for reduction of postprocedure pain: a randomized, double-blind, controlled trial. Gastrointest Endosc. 2009; 70(2):278-83. DOI: 10.1016/j.gie.2008.12.050. View

16.

Ueki T, Mizuno M, Ota S, Ogawa T, Matsushita H, Uchida D . Carbon dioxide insufflation is useful for obtaining clear images of the bile duct during peroral cholangioscopy (with video). Gastrointest Endosc. 2010; 71(6):1046-51. DOI: 10.1016/j.gie.2010.01.015. View

17.

Larghi A, Waxman I . Endoscopic direct cholangioscopy by using an ultra-slim upper endoscope: a feasibility study. Gastrointest Endosc. 2006; 63(6):853-7. DOI: 10.1016/j.gie.2005.07.050. View

18.

Tsou Y, Lin C, Tang J, Liu N, Cheng C . Direct peroral cholangioscopy using an ultraslim endoscope and overtube balloon-assisted technique: a case series. Endoscopy. 2010; 42(8):681-4. DOI: 10.1055/s-0030-1255616. View

19.

Verma D, Gostout C, Petersen B, Levy M, Baron T, Adler D . Establishing a true assessment of endoscopic competence in ERCP during training and beyond: a single-operator learning curve for deep biliary cannulation in patients with native papillary anatomy. Gastrointest Endosc. 2007; 65(3):394-400. DOI: 10.1016/j.gie.2006.03.933. View

20.

Bretthauer M, Seip B, Aasen S, Kordal M, Hoff G, Aabakken L . Carbon dioxide insufflation for more comfortable endoscopic retrograde cholangiopancreatography: a randomized, controlled, double-blind trial. Endoscopy. 2007; 39(1):58-64. DOI: 10.1055/s-2006-945036. View