Division of Gastroenterology and Hepatology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 2360004, Japan.
Gastroenterology Division, Yokohama Sakae Kyosai Hospital, Yokohama, Japan.
Dig Dis Sci. 2022 Jul;67(7):2882-2890. doi: 10.1007/s10620-021-07342-2. Epub 2022 Jan 1.
Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically difficult. Extensive training is required to develop the ability to perform this procedure.
To investigate the learning curve of single-balloon-assisted enteroscopy ERCP (SBE-ERCP).
We conducted a retrospective, observational case series at a single center. We evaluated the SBE-ERCP procedures between April 2011 and February 2021. The main outcomes were the rate of reaching the target site and the success rate of the entire procedure. These parameters were additionally expressed as a learning curve.
A total of 687 SBE-ERCP procedures were analyzed. The learning curve was analyzed in blocks of 10 cases. In this study, seven endoscopists, experts in conventional ERCP, were included. The overall SBE-ERCP procedural success rate was 92.2% (634/687 cases). Combining all data from individual endoscopists' evaluation periods, the insertion and success rates of the SBE-ERCP procedures gradually increased with increased experience performing SBE-ERCP. The insertion success rates for the number of SBE-ERCP cases (< 20, 21-30, > 30) were 82.9%, 92.9%, and 94.3%, respectively; the procedure success rates were 74.3%, 81.4%, and 92.9%, respectively. The endoscopists who had performed > 30 SBE-ERCP cases had a success rate of ≥ 90%.
Our results suggest that performing > 30 cases is one of the targets for conventional ERCP experts to become competent in performing SBE-ERCP in patients with a surgically altered anatomy.
内镜逆行胰胆管造影（ERCP）在解剖结构改变的患者中具有一定难度，需要进行广泛的培训以掌握该技术。
探讨单气囊辅助小肠镜逆行胰胆管造影（SBE-ERCP）的学习曲线。
我们在一家单中心进行了回顾性、观察性病例系列研究。评估了 2011 年 4 月至 2021 年 2 月期间的 SBE-ERCP 操作。主要结局是到达目标部位的比率和整个手术的成功率。这些参数还被表示为学习曲线。
共分析了 687 例 SBE-ERCP 操作。学习曲线以每 10 例为一个块进行分析。本研究包括 7 名在常规 ERCP 方面具有专长的内镜医生。SBE-ERCP 手术的总体成功率为 92.2%（634/687 例）。将每位内镜医生评估期内的所有数据结合起来，随着 SBE-ERCP 经验的增加，SBE-ERCP 操作的插入和成功率逐渐提高。SBE-ERCP 操作例数（<20、21-30、>30）的插入成功率分别为 82.9%、92.9%和 94.3%，手术成功率分别为 74.3%、81.4%和 92.9%。完成 SBE-ERCP 例数>30 的内镜医生的成功率≥90%。
我们的结果表明，完成>30 例手术是常规 ERCP 专家掌握对解剖结构改变的患者进行 SBE-ERCP 的目标之一。
