UK Joint Advisory Group consensus statements for training and certification in endoscopic retrograde cholangiopancreatography
Authors
Siau, KeithKeane, Margaret G
Steed, Helen

Caddy, Grant
Church, Nick
Martin, Harry
McCrudden, Raymond
Neville, Peter
Oppong, Kofi
Rasheed, Ashraf
Sturgess, Richard
Hawkes, Neil
Webster, George
Johnson, Gavin
Issue Date
2022-01-14
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Introduction: Despite the high-risk nature of endoscopic retrograde cholangiopancreatography (ERCP), a robust and standardised credentialing process to ensure competency before independent practice is lacking worldwide. On behalf of the Joint Advisory Group (JAG), we aimed to develop evidence-based recommendations to form the framework of ERCP training and certification in the UK. Methods: Under the oversight of the JAG, a modified Delphi process was conducted with stakeholder representation from the British Society of Gastroenterology, Association of Upper Gastrointestinal Surgeons, trainees and trainers. Recommendations on ERCP training and certification were formulated after formal literature review and appraised using the GRADE tool. These were subjected to electronic voting to achieve consensus. Accepted statements were peer-reviewed by JAG and relevant Specialist Advisory Committees before incorporation into the ERCP certification pathway. Results: In total, 27 recommendation statements were generated for the following domains: definition of competence (9 statements), acquisition of competence (8 statements), assessment of competence (6 statements) and post-certification support (4 statements). The consensus process led to the following criteria for ERCP certification: 1) performing ≥300 hands-on procedures; 2) attending a JAG-accredited ERCP skills course; 3) in modified Schutz 1-2 procedures: achieving native papilla cannulation rate ≥80%, complete bile duct clearance ≥70%, successful stenting of distal biliary strictures ≥75%, physically unassisted in ≥80% of cases; 4) 30-day post-ERCP pancreatitis rates ≤5%; 5) satisfactory performance in formative and summative direct observation of procedural skills (DOPS) assessments. Conclusion: JAG certification in ERCP has been developed following evidence-based consensus to quality assure training and to ultimately improve future standards of ERCP practice.Citation
Siau, K., Keane, M.G., Steed, H. et al. (2022) UK Joint Advisory Group consensus statements for training and certification in endoscopic retrograde cholangiopancreatography. Endoscopy International Open, 10(01): E37-E49. DOI: 10.1055/a-1629-7540Publisher
Thieme OpenJournal
Endoscopy International OpenType
Journal articleLanguage
enDescription
© 2022 The Authors. Published by Thieme Open. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1629-7540 Correction made to the online version on February 18, 2022. Endoscopy International Open 2022; 10(01): C1-C1 DOI: 10.1055/a-1761-7848ISSN
2364-3722ae974a485f413a2113503eed53cd6c53
10.1055/a-1629-7540
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Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-nd/4.0/