Endoscopy 2008; 40(12): 983-988
DOI: 10.1055/s-2008-1077777
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Comparison of accessory performance using a novel ERCP mechanical simulator[1]

J.  W.  Leung1, 2 , W.  Lee3 , R.  Wilson2 , B.  S.  Lim2 , F.  W.  Leung4, 5
  • 1Section of Gastroenterology, Sacramento Veterans Affairs Medical Center, Veterans Affairs Northern California Healthcare System, Mather, California, USA
  • 2University of California, Davis Medical Center, Sacramento, California, USA
  • 3Endoscopy Center, Tianjian Union Medical Center, Tianjian, China
  • 4Research and Medical Services, Sepulveda Ambulatory Care Center and Nursing Home, Sepulveda, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
  • 5David Geffen School of Medicine at UCLA, Los Angeles, California, USA
Further Information

Publication History

submitted 3 June 2008

accepted after revision 12 September 2008

Publication Date:
08 December 2008 (online)

Background and study aims:There is a paucity of in vitro methods for evaluating ERCP accessories. We hypothesize that the time taken to perform a simulated single stent or multiple stents placement is different for stenting systems with or without the capability of intraductal ductal release (IDR) of the guide wire.

Patients and methods:We conducted an un-blinded in vitro comparison of ERCP accessories using a mechanical simulator during hands-on ERCP practice workshops. A total of 21 U.S. participants and 20 Chinese participants with various level of ERCP experience took part in the different practice workshops. Accessories with and without the capability of intraductal release of guide wire were compared. Total time required for completing a simulated stenting procedure with single or multiple stents and the respective simulated fluoroscopy time were recorded.

Results:There was no significant difference in the time taken for placement of a single stent using either stenting systems. Stenting system capable of intraductal release of the guide wire required significantly shorter time to complete placement of three stents.

Conclusions:Using time required to complete a specific task, i. e. biliary stenting, the mechanical simulator permits the performance of different accessories by the same group of operators to be evaluated objectively.

1 Part of the data was presented as a poster in the 2007 ACG meeting in Philadelphia

References

  • 1 Cohen J. Training and credentialing in gastrointestinal endoscopy in endoscopy practice and safety. In: Cotton P, ed. Advanced endoscopy. E-book; Gastrohep.com 2005: 1-50
  • 2 Neumann M, Mayer G, Ell C. et al . The Erlangen Endo-Trainer: life-like simulation for diagnostic and interventional endoscopic retrograde cholangiography.  Endoscopy. 2000;  32 906-910
  • 3 Matthes K, Cohen J. The Neo-Papilla: a new modification of porcine ex vivo simulators for ERCP training.  Gastrointest Endosc. 2006;  64 570-576
  • 4 Sedlack R, Petersen B, Binmoeller K, Kolars J. A direct comparison of ERCP teaching models.  Gastrointest Endosc. 2003;  57 886-890
  • 5 Bar-Meir S. Simbionix simulator.  Gastrointest Endosc Clin N Am. 2006;  16 471-478, vii
  • 6 Leung J W, Lee J, Rojany M. et al . Development of a novel ERCP mechanical simulator.  Gastrointest Endosc. 2007;  65 1056-1062
  • 7 Frimberger E, von Dellus S, Rösch T. et al . A novel and practicable ERCP training system with simulated fluoroscopy.  Endoscopy. 2008;  40 517-520
  • 8 Leung J. Fundamentals of ERCP. In: Cotton P, Leung J, eds. Advanced digestive endoscopy: ERCP. Oxford; Blackwell 2005
  • 9 Leung J W. Is there a role for metal stents in benign bile duct strictures? When should I use plastic stents in this setting?. In: Leung JW, Lo S, ed. Curbside Consultation in Endoscopy: 49 Clinical Questions. Thorofare, NJ; Slack Incorp 2008: 85-88
  • 10 Borkovec T D, Nau S D. Credibility of analogue therapy rationales.  J Behav Ther Exp Psychiatry. 1972;  3 257-260
  • 11 Whitehead W E. Control groups appropriate for behavioral interventions.  Gastroenterology. 2004;  126 S159-S163
  • 12 Costamagna G, Pandolfi M, Mutignani M. et al . Long term results of endoscopic management of postoperative bile duct strictures with increasing number of stents.  Gastrointest Endosc. 2001;  54 162-168
  • 13 Bergman J, Burgemeister L, Bruno M. et al . Long term follow up after biliary stent placement for postoperative bile duct stenosis.  Gastrointest Endosc. 2001;  54 154-161
  • 14 Kuzela L, Oltman M, Sutka J. et al . Prospective follow-up of patients with bile duct strictures secondary to laparoscopic cholecystectomy, treated endoscopically with multiple stents.  Hepatogastroenterology. 2005;  52 1357-1361

1 Part of the data was presented as a poster in the 2007 ACG meeting in Philadelphia

J. W. LeungMD 

Section of Gastroenterology
Sacramento VA Medical Center

10535 Hospital Way
Mather
CA 95655
USA

Fax: +1-916-7347908

Email: jwleung@ucdavis.edu

    >