Abstract
Introduction: ERCP is a technically challenging procedure. Biliary cannulation success appears to be influenced by both patient and practitioner factors. Previous studies have shown that volume, training, and practice conditions may play a role (Peng C et al 2013). Over the years, the role of nurses in endoscopy has expanded. In one study by (Dellon ES et al 2009), they found that GI endoscopy nurse inexperience was associated with an increase in immediate complications, prolonged procedure times, and decreased cecal- intubation rates for screening colonoscopies. To date no study examined the effect of endoscopy nurse experience on ERCP duration. In this study, we aim to examine whether the level of experience of endoscopy nurse will have an impact on the ERCP duration. Methods: This is a single center, retrospective analysis of all ERCP procedures performed at a tertiary care referral center with a high volume endoscopy unit between 2012 and 2018. We excluded patients who had more than one ERCP. Procedures were also excluded if a training fellow was involved. Data was extracted retrospectively. It included indication, procedure duration, procedural techniques , diagnoses and complications. Procedures were performed by five endoscopists. They were divided into two groups; an experienced group with more than 15 years experience in the field this applied to three endoscopists. The second group had two junior endoscopists with less than five years experience. The total number of nurses during the study period was 18. Nurses were also divided into two groups based on their years of experience in ERCP. Those with 10 years or more experience doing ERCP were considered experienced. Nurses with less than 10 years in the field were considered less experienced. The primary outcome of the study was the correlation between endoscopy nurse experience and procedure duration. Secondary outcomes included success of cannulation, complication, technical difficulty. Results: The final analysis included 860 ERCPs. We found no significant difference association between the duration and the level of experience of the nurse involved . This remained the case with simple and multiple linear regression. Conclusion: This retrospective study shows that the nurse's experience in assisting n ERCP had no influence on the duration of the procedure. This did not change whether the endoscopist involved was a senior or junior attending.