The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS). This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in ERCP and EUS. This curriculum is set out in terms of the prerequisites prior to training; recommended steps of training to a defined syllabus; the quality of training; and how competence should be defined and evidenced before independent practice. 1: Trainees should be competent in gastroscopy prior to commencing training. Formal training courses and the use of simulation in training are recommended. 2: Trainees should keep a contemporaneous logbook of their procedures, including key performance indicators and the degree of independence. Structured formative assessment is encouraged to enhance feedback. There should be a summative assessment process prior to commencing independent practice to ensure there is robust evidence of competence. This evidence should include a review of a trainee's procedure volume and current performance measures. A period of mentoring is strongly recommended in the early stages of independent practice. 3: Specifically for ERCP, all trainees should be competent up to Schutz level 2 complexity (management of distal biliary strictures and stones > 10 mm), with advanced ERCP requiring a further period of training. Prior to independent practice, ESGE recommends that a trainee can evidence a procedure volume of > 300 cases, a native papilla cannulation rate of ≥ 80 % (90 % after a period of mentored independent practice), complete stones clearance of ≥ 85 %, and successful stenting of distal biliary strictures of ≥ 90 % (90 % and 95 % respectively after a mentored period of independent practice). 4: The progression of EUS training and competence attainment should start from diagnostic EUS and then proceed to basic therapeutic EUS, and finally to advanced therapeutic EUS. Before independent practice, ESGE recommends that a trainee can evidence a procedure volume of > 250 cases (75 fine-needle aspirations/biopsies [FNA/FNBs]), satisfactory visualization of key anatomical landmarks in ≥ 90 % of cases, and an FNA/FNB accuracy rate of ≥ 85 %. ESGE recognizes the often inadequate quality of the evidence and the need for further studies pertaining to training in advanced endoscopy, particularly in relation to therapeutic EUS.

Centre for Therapeutic Endoscopy 1st Department of Surgery and Interventional Gastroenterology Semmelweis University Budapest Hungary

Department of Gastroenterology and Hepatology Erasmus MC University Medical Center Rotterdam The Netherlands

Department of Gastroenterology and Hepatology IKEM Prague Czech Republic

Department of Gastroenterology and Hepatology Université catholique de Louvain CHU UCL Namur Yvoir Belgium

Department of Gastroenterology and Hepatology University Hospital Zurich Switzerland

Department of Gastroenterology and Hepatology University Hospitals Leuven and TARGID KU Leuven Leuven Belgium

Department of Gastroenterology Hepatopancreatology and Digestive Oncology CUB Hôpital Erasme Université Libre de Bruxelles Brussels Belgium

Department of Gastroenterology Medical School and University Hospital of Ioannina Ioannina Greece

Department of Gastroenterology University Hospital of Heraklion University of Crete Heraklion Greece

Department of Gastrointestinal Surgery Helsinki University Hospital Helsinki Finland

Department of Internal Medicine 3 University Hospital Augsburg Augsburg Germany

Department of Medicine University of Szeged Szeged Hungary

Department of Surgical and Perioperative Sciences Surgery Umeå University Umeå Sweden

Digestive Disease Center University Hospital of Copenhagen Herley University of Copenhagen Copenhagen Denmark

Division of Gastroenterology Digestive Endoscopy Unit Humanitas Clinical and Research Center IRCCS Rozzano Italy

Endoscopy Unit Gastroenterology Department Complejo Hospitalario de Navarra Instituto de Investigaciones Sanitarias de Navarra Pamplona Spain

Gastroenterology and Digestive Endoscopy Fondazione Policlinico Gemelli Rome Italy

Gastroenterology Department Digestive Unit Champalimaud Foundation Lisbon Portugal

Gastroenterology Department IPO Porto Porto Portugal

Gastroenterology Division Edouard Herriot Hospital Lyon France

John Radcliffe Hospital Oxford University Hospitals Foundation Trust Oxford UK

Moscow Clinical Scientific Center n a A S Loginov Moscow Russia

Pancreato Biliary Endoscopy and Endosonography Division Pancreas Translational and Clinical Research Center San Raffaele Scientific Institute IRCCS Milan Italy

Regional Institute of Gastroenterology and Hepatology Cluj Napoca University of Medicine and Pharmacy Iuliu Hatieganu Cluj Napoca Romania

University College London Hospitals London UK

Citace poskytuje Crossref.org

Endoscopic retrograde cholangiopancreatography training conditions, results from a pan-European survey: Between vision and reality