Experienced ERCP Doctor
Endoscopic retrograde cholangiopancreatography, or ERCP, is a medical procedure that is used to examine and in some cases treat blockages in the biliary and pancreatic ducts. ERCP is not surgery, and in most cases ERCP carries a lower risk factor than other forms of treatment for blockage issues. However, complications occur in roughly one to five percent of ERCP procedures performed.
ERCP Experience
Many factors may influence the risk of complications, especially the condition of the patient and the specific medical issue being treated or examined. Having an experienced ERCP doctor is the best way to ensure a smooth ERCP.
Benefits of ERCP Doctor Experience
A doctor that is familiar with performing ERCP is more likely to anticipate problems before they occur. An experienced ERCP doctor will also be more comfortable making calls in the moment. This is important because in most cases ERCP is used to diagnose the exact cause of blockage, then treatment is decided upon and performed immediately.
What Constitutes Proficiency in ERCP?
A doctor training to perform ERCP is considered experienced enough to perform the procedure on their own when they can demonstrate certain ERCP skills, including:
- Perform a sphincterotomy
- Insert a drainage tube into desired duct
- Gather information from diagnosis and form an effective treatment plan
- Accomplish decompression of biliary or pancreatic duct
Although these are the standardized benchmarks used to gauge competency, an experienced ERCP doctor should also be able to perform ERCP treatment tasks. This includes placing stents, removing stones, and managing hemorrhaging caused by sphincterotomy.
There are also advanced techniques that experienced ERCP doctors can master. These include stricture dilation, metallic endoprosthesis, and precut sphincterotomy. Ask your doctor about their proficiency with these procedures to get an idea of their ERCP skill level.
How do Doctors Train for ERCP?
Doctors often begin training for ERCP on animal models or computer simulations. Through these methods, physicians gain experience with maneuvering the endoscope and grow accustomed to ERCP without putting patients in danger.
Once a physician has gained enough experience and knowledge this way, they will participate in many ERCP procedures as an assistant or under supervision before they will be granted the clinical privilege of performing the procedure in the lead physician role. There is no specific number of ERCP procedures that a doctor has to complete be considered an experienced ERCP doctor.
Experienced ERCP doctors are responsible for maintaining their ERCP procedure skills. This entails receiving training on new technologies when they are developed, as well as performing ERCP often to keep knowledge fresh and skills sharp.
Sources:
“ERCP.” National Digestive Diseases Information Clearinghouse (NDDIC). National Digestive Diseases Information Clearinghouse, 29 Jun 2012. Web. 12 Jul 2013. <http://digestive.niddk.nih.gov/ddiseases/pubs/ercp/
“Guidelines for Training in Diagnostic and Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP).” SAGES Society of American Gastrointestinal and Endoscopic Surgeons. Society of American Gastrointestinal and Endoscopic Surgeons, n.d. Web. 12 Jul 2013. <http://www.sages.org/publications/guidelines/guidelines-for-training-in-diagnostic-and-therapeutic-endoscopic-retrograde-cholangiopancreatography-ercp/>.
“Understanding ERCP.” ASGE: American Society for Gastrointestinal Endoscopy. American Society for Gastrointestinal Endoscopy, n.d. Web. 12 Jul 2013. <http://www.asge.org/patients/patients.aspx?id=386>.
Yen, Danny, and Joseph Leung. “ERCP training — the potential role of simulation practice.” PMC U.S.National Library of Medicine National Institutes of Health. National Center for Biotechnology Information, U.S. National Library of Medicine, n.d. Web. 12 Jul 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109468/>.