ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN A GENERAL-SURGERY TRAINING-PROGRAM

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the mo st complex procedures performed by endoscopists. ERCP has been perform ed primarily by gastroenterologists. There have been no reports in the literature regarding ERCP training within the framework of a general surgery residency program. The purpose of this study was to review ERC Ps performed by surgical attendings and resident staff during a 6-year period and compare the success and complication rates with those foun d in published gastroenterological series. There were a total of 193 E RCPs performed on 171 patients for a success rate of 82.4 per cent and a complication rate of 6.7 per cent. A resident was the primary endos copist in 51 procedures, with 42 (82.4%) successes and 2 complications (3.9%). There were no significant differences noted between our serie s and national complication rates, and between attending and resident procedures (P < 0.05, Chi-square analysis). This study has shown that surgical endoscopists can perform ERCP with success rates over 80 per cent, the currently regarded standard of expertise. The complication r ates for these ERCPs were lower than accepted complication rates cited in current gastroenterological series. The results of this study supp ort the hypothesis that ERCPs can be performed safely in a surgical re sidency.