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Complications of endoscopic retrograde cholangiopancreatography during live endoscopy workshop demonstrations.

BACKGROUND AND STUDY AIMS
Endoscopy workshops are thought to be associated with larger numbers of complications than routine clinical treatment. In this study, patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) during live demonstrations were compared with matched patients treated in an ERCP unit.


PATIENTS AND METHODS
Patients who underwent ERCP during workshops over a 12-year period were reviewed. The control for each patient was the next patient admitted to the same ERCP unit with similar indications. Possible delays before treatment, ERCP indications, the use of general anesthesia, standard endoscopic and special treatments, success and complication rates for ERCP, prolonged hospitalization periods, and financial benefits for patients were assessed.


RESULTS
A total of 168 workshop patients and 168 control patients were compared. ERCP was delayed in 18 patients to allow treatment during the workshops. General anesthesia was used in 87.5 % of the workshop patients, in comparison with 44 % of the control patients (P < 0.001). The duration of the endoscopies and radiation exposure did not differ, and the endoscopic treatments carried out also did not differ significantly, with the exception of cholangiopancreatoscopy (7 % in the workshop group versus 0 %; P < 0.01). The success and complication rates were similar in the workshop and control patients, as was the duration of hospitalization. Among the patients treated during workshops, 45 % benefited financially, as they were not charged for stents or other devices.


CONCLUSIONS
These results suggest that, in this setting, ERCP performed during live demonstrations is safe and raises no major ethical problems.