ERCP in China—training status and market overview

ERCP in China—training status and market overview

Since the first ERCP operation made in China in 1973, ERCP operation successful rate has rised to 96.1% from 84%, with complications controlled around 5%.

Where there is a will, there is a way.The successful prevailing of ERCP operation in China is the fruit of enormous efforts of strenuous practice and never-remitting exploration.

ERCP training plays key role in the technique development.

The patients take benefit while the physicians overcome difficulties one after another.

The GI endoscope branch of Chinese Medical Association took its birth due to the demand of ERCP academic promotion. Every year, it holds symposiums and hand-by–hand trainings in cities across the country. The progressing way is tortuous not straight.

For example, we make some mistakes in credential approval. At the beginning, training time instead of case numbers was set as the approval principle.

The hand-by-hand training was lacking in standards. For example, when should the student try advanced technique like dual-guide wire and preloading of pancreatic stent?

Shall the independent operation by the student lead to more risk of complications? Regarding complications, how to treat and handle it properly in trainings?

Even after the physicians complete trainings, some other elements are also crucial for ERCP technique practice and promotion, for example, support from the hospital and sufficient patients source.

Some physicians were doing open surgery previously and they just do not have the patience to overcome the difficulties like less support from the hospitals at the beginning, although they have enough anastomotic knowledge to do endoscopic operation well.

Some endoscopic physicians are confident at controlling the flexible endoscope, but not that good at minimize complications. However, they often persist in practicing thetechniquewith more prudent attitude.

Gradually we accumulated valuable training experience adapted to good ERCP training and practice in China.

(From ERCP Re-recognition: meditation of training and quality control,  by ZHONGGUO XIJING DIGESTIVE INSTITUTE 2017 Internal training material ）

．Screening of student

As what we have mentioned, choose correct candidate from endoscopic physicians and open surgery physicians according to their respective features.

﹒ Training process

Quantity should be emphasized, while 100-200 cases should be the suggestions with period 6-12 months.

﹒After training

Good training ≠ good practice

Enough cases: > 50-100 cases

The support from hospitals and the department

Further analysis of ERCPology（From China Practical Internal Medicine Magazine, Edition 10, May 2006）

Table 1: Chinese ERCP patients analysis and ”potential market”

Image 1: Pre-ERCP “5W”