Ostroff James W
Endoscopy Unit, Moffit Long and Mt Zion Cancer Center Hospitals, University of California, San Francisco, CA 94117, USA.
Semin Gastrointest Dis. 2003 Oct;14(4):222-36.
Therapeutic biliary and pancreatic endoscopy has evolved over the last 30 years to a level where it represents the primarily mode of therapy for many frequently encountered diseases of the bile ducts liver and pancreas. The complication rates are expected to be low and the expectations of our colleagues are high. The endoscopist is expected to understand the origin and natural history of these diseases and the consequences of the various management options. The training of the endoscopist has taken on a very formal character, as has the emphasis on competency and quality improvement. The appearance of minimally invasive surgery and advanced imaging does not represent a threat to the biliary endoscopist but rather is complimentary and assists us so that unnecessary potentially morbid procedures are not done unnecessarily. The appearance of a new specialty: the minimally invasive biliary interventionalist, who would receive training by gastroenterologists, interventional radiologist and biliary-pancreatic surgeons, is the logical next step!
在过去30年里，治疗性胆胰内镜已发展到这样一个水平：它已成为许多常见胆管、肝脏和胰腺疾病的主要治疗方式。人们期望并发症发生率较低，同时我们的同行对其期望也很高。期望内镜医师了解这些疾病的起源、自然病史以及各种治疗选择的后果。内镜医师的培训已具有非常正规的性质，对能力和质量改进的重视也是如此。微创外科手术和先进成像技术的出现对胆胰内镜医师来说并不构成威胁，反而具有互补性并能帮助我们，使不必要的潜在高风险手术不会被不必要地实施。一个新的专业领域——微创胆胰介入专家的出现是合乎逻辑的下一步，这些专家将接受胃肠病学家、介入放射学家和胆胰外科医生的培训！
