ArticleSurgical endoscopy2026
Efficacy and determinants of success in a structured ERCP training program: a retrospective cohort study from a national training center in China.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEndoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure, and there is a significant shortage of trained practitioners in China.
aimTo evaluate effectiveness of a structured ERCP training program at a national training center and identify key determinants of success.
methodsA retrospective cohort study was conducted among 68 graduates (response rate 62.5%) of the ERCP training program at Beijing Friendship Hospital (2017-2024). Data on demographics, training content, and post-training ERCP practice were collected via questionnaire. Primary competence was defined as performing > 10 ERCPs annually with a cannulation success rate ≥ 70% (entry-level). A secondary analysis used the > 90% cannulation rate (advanced mastery) to align with international benchmarks. Multivariate logistic regression identified factors associated with competence.
resultsMost trainees (83.8%) successfully performed ERCP post-training; 63.2% achieved entry-level competence, while only 25.0% reached the advanced ≥ 90% standard. Subgroup analysis showed that 3-month and 6-month groups achieved higher entry-level competence (69.6% and 67.7%, respectively) than the 12-month group (42.9%), attributed to greater weekly hands-on density. Multivariate analysis identified longer training duration (OR 1.32, P = 0.011), greater weekly hands-on opportunities (OR 2.05, P = 0.013), and sufficient mentor guidance (OR 3.49, P = 0.016) as independent predictors.
conclusionThe structured ERCP training program effectively establishes entry-level competence for most trainees, but achieving international mastery remains challenging. Success is associated with adequate training duration, frequent hands-on experience, and quality mentorship. We propose a tiered accreditation system and post-training remediation pathways to safely address the national shortage of ERCPists.
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