Appropriate time for selective biliary cannulation by trainees during ERCP - a randomized trial
Appropriate time for selective biliary cannulation by trainees during ERCP - a randomized trial
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DOI：
10.1055/s-0034-1391564
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发表时间：
2015-08-01
期刊：
影响因子：
9.3
通讯作者：
Guo, Xuegang
中科院分区：
文献类型：
--
作者：
Pan, Yanglin;Zhao, Lina;Guo, Xuegang
背景和研究目的：为受训者分配足够的时间尝试插管对于学习和确保内窥镜逆行胰胆管造影术（ERCP）培训的成功是必要的。然而，重要的是要平衡学员实践的受益与患者的潜在风险。由受训者尝试插管的适当时间仍不清楚。患者和方法：三个不同的时间限制（5，10，15分钟）设置为插管尝试由四名受训者在接受ERCP的患者与本机乳头。患者以1：1：1的比例随机分配到5分钟、10分钟或15分钟组。直肠消炎痛用于高危患者。主要结局是在指定时间内成功插管。次要结果包括性能评分、总体成功率和ERCP术后胰腺炎（PEP）。结果：共有256例患者被随机分配到5分钟组（n=84）、10分钟组（n=86）和15分钟组（n=86）。患者的基线特征相当。在5分钟、10分钟和15分钟组，受训者选择性胆管插管的成功率分别为43.8%、75.0%和71.8%（P
Background and study aim: The allocation of sufficient time for trainees to attempt cannulation is necessary for learning and to ensure success with endoscopic retrograde cholangiopancreatography (ERCP) training. However, it is important to balance the benefit to trainee practice against the potential risks to patients. The appropriate time for attempted cannulation by trainees remains unclear.Patients and methods: Three different time limits (5, 10, 15 minutes) were set for cannulation attempts made by four trainees in patients with native papilla undergoing ERCP. Patients were randomly assigned to the 5-, 10-, or 15-minute groups in a 1: 1: 1 ratio. Rectal indomethacin was used in high-risk patients. The primary outcome was successful cannulation within the allocated time. Secondary outcomes included performance scores, overall success rate, and post-ERCP pancreatitis (PEP).Results: A total of 256 patients were randomly assigned to the 5-minute (n=84), 10-minute (n=86), or 15-minute (n=86) groups. Patients' base-line characteristics were comparable. Success rates for selective bile duct cannulation by trainees were 43.8 %, 75.0 %, and 71.8% in the 5-, 10-, and 15-minute groups, respectively (P