CLINICAL OUTCOMES AND LEARNING CURVE FOR ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY DURING ADVANCED ENDOSCOPY TRAINING: A COMPARISON OF SUPINE VERSUS PRONE POSITIONING.

Overview

BACKGROUND & AIM: No prior studies evaluated trainees' outcomes when learning ERCP in supine and prone positions simultaneously. We aimed to assess whether patient position impacts procedural outcomes and learning curve. METHODS: We prospectively evaluated patients undergoing ERCP by a supervised advanced endoscopy trainee (AET) at a tertiary-care center. Adult patients with native papillae were included. The AET was universally given 5 attempts per cannulation. Outcomes were evaluated quarterly. RESULTS: Successful cannulation was achieved in 44(69%) supine and in 17(68%) prone patients (P=0.95). Although mean time-to-papilla was shorter in supine, time-to-biliary cannulation (7.8 vs 9.4min; P=0.53) and number of attempts were similar. A stepwise increase was seen in cannulation rates throughout the academic year (P<0.01); and increased more in supine (P=0.01). Procedure and total room times were shorter in supine. CONCLUSIONS: Shorter procedure and room turnover times, and a comparable cannulation rate were found for supine vs. prone ERCP.