Endoscopy 2023; 55(03): 276-293
DOI: 10.1055/a-2003-5818
Position Statement

Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Ivo Boškoski 
 1   Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
,
Valerio Pontecorvi
 1   Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
,
Mostafa Ibrahim
 2   Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt
,
Vincent Huberty
 3   Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université libre de Bruxelles (ULB), Brussels, Belgium
,
Roberta Maselli
 4   Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Italy
,
Stefan K. Gölder 
 5   Department of Internal Medicine, Ostalb Klinikum Aalen, Aalen, Germany
,
Jan Kral
 6   Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
,
Jayanta Samanta 
 7   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Árpád V. Patai
 8   Division of Gastroenterology, Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary
,
Rehan Haidry
 9   Department of Gastroenterology, University College London Hospital, London, UK
,
Marcus Hollenbach 
10   Medical Department II, Division of Gastroenterology, University of Leipzig Medical Center, Leipzig, Germany
,
Enrique Pérez-Cuadrado-Robles 
11   Department of Gastroenterology, Georges-Pompidou European Hospital, Paris, France
,
Marco Silva 
12   Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
,
Helmut Messmann
13   Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
,
Tony C. Tham 
14   Division of Gastroenterology, Ulster Hospital, Dundonald, Belfast, Northern Ireland
,
Raf Bisschops 
15   Department of Gastroenterology and Hepatology, University Hospital Leuven, TARGID, KU Leuven, Leuven, Belgium
› Author Affiliations
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Main recommendations

Obesity is a chronic, relapsing, degenerative, multifactorial disease that is associated with many co-morbidities. The global increasing burden of obesity has led to calls for an urgent need for additional treatment options. Given the rapid expansion of bariatric endoscopy and bariatric surgery across Europe, the European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This curriculum is set out in terms of the prerequisites prior to training, minimum number of procedures, the steps for training and quality of training, and how competence should be defined and evidenced before independent practice.

1 ESGE recommends that every endoscopist should have achieved competence in upper gastrointestinal endoscopy before commencing training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events.

2 Trainees in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery should have basic knowledge of the definition, classification, and social impact of obesity, its pathophysiology, and its related co-morbidities. The recognition and management of gastrointestinal diseases that are more common in patients with obesity, along with participation in multidisciplinary teams where obese patients are evaluated, are mandatory.

3 ESGE recommends that competency in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery can be learned by attending validated training courses on simulators initially, structured training courses, and then hands-on training in tertiary referral centers.



Publication History

Article published online:
25 January 2023

© 2023. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 World Health Organization. Obesity and overweight. 2021 https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight Accessed: 29 November 2022
    PubMedGoogle Scholar
  • 2 Ponce J, DeMaria EJ, Nguyen NT. et al. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in 2015 and surgeon workforce in the United States. Surg Obes Relat Dis 2016; 12: 1637-1639
    Google Scholar
  • 3 Currie AC, Askari A, Newton RC. et al. Regional variation in unmet need for metabolic surgery in England: a retrospective, multicohort analysis. Obes Surg 2021; 31: 439-444
    CrossrefPubMedGoogle Scholar
  • 4 Kheirvari M, Dadkhah Nikroo N, Jaafarinejad H. et al. The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review. Heliyon 2020; 6: e03496
    CrossrefPubMedGoogle Scholar
  • 5 Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc 2013; 78: 530-535
    CrossrefPubMedGoogle Scholar
  • 6 Ge PS, Thompson CC. The use of the Overstitch to close perforations and fistulas. Gastrointest Endosc Clin N Am 2020; 30: 147-161
    CrossrefPubMedGoogle Scholar
  • 7 Donatelli G, Cereatti F, Dhumane P. et al. Closure of gastrointestinal defects with Ovesco clip: long-term results and clinical implications. Ther Adv Gastroenterol 2016; 9: 713-721
    CrossrefPubMedGoogle Scholar
  • 8 Nachira D, Trivisonno A, Costamagna G. et al. Successful therapy of esophageal fistulas by endoscopic injection of emulsified adipose tissue stromal vascular fraction. Gastroenterology 2021; 160: 1026-1028
    CrossrefPubMedGoogle Scholar
  • 9 Tringali A, Bove V, Perri V. et al. Endoscopic treatment of post-laparoscopic sleeve gastrectomy leaks using a specifically designed metal stent. Endoscopy 2017; 49: 64-68
    PubMedGoogle Scholar
  • 10 Donatelli G, Spota A, Cereatti F. et al. Endoscopic internal drainage for the management of leak, fistula, and collection after sleeve gastrectomy: our experience in 617 consecutive patients. Surg Obes Relat Dis 2021; 17: 1432-1439
    CrossrefPubMedGoogle Scholar
  • 11 Rutter MD, Senore C, Bisschops R. et al. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures. Endoscopy 2016; 48: 81-89
    PubMedGoogle Scholar
  • 12 Dekker E, Houwen BBSL, Puig I. et al. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52: 899-923
    Google Scholar
  • 13 Sidhu R, Chetcuti Zammit S, Baltes P. et al. Correction: Curriculum for small-bowel capsule endoscopy and device-assisted enteroscopy training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52: 669-686
    Google Scholar
  • 14 Pimentel-Nunes P, Pioche M, Albéniz E. et al. Curriculum for endoscopic submucosal dissection training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2019; 51: 980-992
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Johnson G, Webster G, Boškoski I. et al. Curriculum for ERCP and endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2021; 53: 1071-1087
    Google Scholar
  • 16 Dumonceau JM, Hassan C, Riphaus A. et al. European Society of Gastrointestinal Endoscopy (ESGE) Guideline Development Policy. Endoscopy 2012; 44: 626-629
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Guyatt GH, Oxman AD, Vist GE. et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008; 336: 924-926
    CrossrefPubMedGoogle Scholar
  • 18 Jirapinyo P, Thompson CC. How to incorporate bariatric training into your fellowship program. Gastroenterology 2021; 161: 15-20
    CrossrefPubMedGoogle Scholar
  • 19 Bisschops R, Areia M, Coron E. et al. Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2016; 48: 843-864
    Google Scholar
  • 20 ASGE Bariatric Endoscopy Task Force and ASGE Technology Committee, Abu Dayyeh BK, Kumar N. et al. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc 2015; 82: 425-438.e5
    CrossrefPubMedGoogle Scholar
  • 21 Carr P, Keighley T, Petocz P. et al. Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support. BMC Prim Care 2022; 23: 26
    CrossrefPubMedGoogle Scholar
  • 22 Neto MG, Silva LB, de Quadros LG. et al. Brazilian consensus on endoscopic sleeve gastroplasty. Obes Surg 2021; 31: 70-78
    CrossrefPubMedGoogle Scholar
  • 23 Sarkar A, Tawadros A, Andalib I. et al. Safety and efficacy of endoscopic sleeve gastroplasty for obesity management in new bariatric endoscopy programs: a multicenter international study. Ther Adv Gastrointest Endosc 2022; 15 DOI: 10.1177/26317745221093883.
    CrossrefPubMedGoogle Scholar
  • 24 Matteo MV, Bove V, Pontecorvi V. et al. Endoscopic sleeve gastroplasty as a therapeutic chance for obese patients not eligible for organ transplantation. Obes Surg 2022; 32: 2460-2462
    CrossrefPubMedGoogle Scholar
  • 25 Matteo MV, D’Oria M, Bove V. et al. Personalized approach for obese patients undergoing endoscopic sleeve gastroplasty. J Pers Med 2021; 11: 1298
    CrossrefPubMedGoogle Scholar
  • 26 US Food and Drug Administration. Summary of Safety and Effectiveness Data. 2015 https://www.accessdata.fda.gov/cdrh_docs/pdf14/p140012b.pdf Accessed: 29 November 2022
    PubMedGoogle Scholar
  • 27 US Food and Drug Administration. Summary of Safety and Effectiveness Data. 2016 https://www.accessdata.fda.gov/cdrh_docs/pdf16/P160001b.pdf Accessed: 29 November 2022
    PubMedGoogle Scholar
  • 28 Pontecorvi V, Bove V, Carlino G. et al. Spontaneous intragastric balloon hyperinflation is probably due to microbial overgrowth of the filling liquid. Obes Surg 2022; 32: 1783-1785
    CrossrefPubMedGoogle Scholar
  • 29 Thompson CC, Abu Dayyeh BK, Kushner R. et al. Percutaneous gastrostomy device for the treatment of class II and Class III obesity: results of a randomized controlled trial. Am J Gastroenterol 2017; 112: 447-457
    CrossrefPubMedGoogle Scholar
  • 30 Yorke E, Switzer NJ, Reso A. et al. Intragastric balloon for management of severe obesity: a systematic review. Obes Surg 2016; 26: 2248-2254
    CrossrefPubMedGoogle Scholar
  • 31 Kim SH, Chun HJ, Choi HS. et al. Current status of intragastric balloon for obesity treatment. World J Gastroenterol 2016; 22: 5495-5504
    CrossrefPubMedGoogle Scholar
  • 32 Evans JT, DeLegge MH. Intragastric balloon therapy in the management of obesity: why the bad wrap?. JPEN J Parenter Enteral Nutr 2011; 35: 25-31
    CrossrefPubMedGoogle Scholar
  • 33 De Peppo F, Caccamo R, Adorisio O. et al. The Obalon swallowable intragastric balloon in pediatric and adolescent morbid obesity. Endosc Int Open 2017; 5: E59-E63
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Mion F, Ibrahim M, Marjoux S. et al. Swallowable Obalon® gastric balloons as an aid for weight loss: a pilot feasibility study. Obes Surg 2013; 23: 730-733
    CrossrefPubMedGoogle Scholar
  • 35 Nobili V, Della Corte C, Liccardo D. et al. Obalon intragastric balloon in the treatment of paediatric obesity: a pilot study. Pediatr Obes 2018; 13: 273
    CrossrefPubMedGoogle Scholar
  • 36 Konopko-Zubrzycka M, Baniukiewicz A, Wróblewski E. et al. The effect of intragastric balloon on plasma ghrelin, leptin, and adiponectin levels in patients with morbid obesity. J Clin Endocrinol Metab 2009; 94: 1644-1649
    CrossrefPubMedGoogle Scholar
  • 37 Abu Dayyeh BK, Maselli DB, Rapaka B. et al. Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial. Lancet 2021; 398: 1965-1973
    CrossrefPubMedGoogle Scholar
  • 38 Singh A, Gelrud A. Adverse events associated with percutaneous enteral access. Gastrointest Endosc Clin N Am 2015; 25: 71-82
    CrossrefPubMedGoogle Scholar
  • 39 Anderloni A, Di Leo M, Barzaghi F. et al. Complications and early mortality in percutaneous endoscopic gastrostomy placement in Lombardy: A multicenter prospective cohort study. Dig Liver Dis 2019; 51: 1380-1387
    CrossrefPubMedGoogle Scholar
  • 40 Iyer KR, Crawley TC. Complications of enteral access. Gastrointest Endosc Clin N Am 2007; 17: 717-729
    CrossrefPubMedGoogle Scholar
  • 41 Wiesen AJ, Sideridis K, Fernandes A. et al. True incidence and clinical significance of pneumoperitoneum after PEG placement: a prospective study. Gastrointest Endosc 2006; 64: 886-889
    CrossrefPubMedGoogle Scholar
  • 42 Imam Z, Simons-Linares CR. Transhepatic insertion of percutaneous endoscopic gastrostomy tube. Case Rep Gastrointest Med 2020; 2020: 4516032
    PubMedGoogle Scholar
  • 43 Wiggins TF, Kaplan R, DeLegge MH. Acute hemorrhage following transhepatic PEG tube placement. Dig Dis Sci 2007; 52: 167-169
    CrossrefPubMedGoogle Scholar
  • 44 Guloglu R, Taviloglu K, Alimoglu O. Colon injury following percutaneous endoscopic gastrostomy tube insertion. J Laparoendosc Adv Surg Tech A 2003; 13: 69-72
    CrossrefPubMedGoogle Scholar
  • 45 Ligresti D, Barbuscio I, Granata A. et al. Endoscopic closure of gastrocolocutaneous fistula following percutaneous endoscopic gastrostomy, by OverStitch Endoscopic Suturing System. Endoscopy 2019; 51: E384-E385
    Article in Thieme ConnectPubMedGoogle Scholar
  • 46 Nunes G, Paiva de Oliveira G, Cruz J. et al. Long-term gastrocolocutaneous fistula after endoscopic gastrostomy: how concerned should we be?. GE Port J Gastroenterol 2019; 26: 441-447
    CrossrefPubMedGoogle Scholar
  • 47 Rodrigues-Pinto E, Santos AL, Macedo G. Endoscopic closure of a colocutaneous fistula after placement of percutaneous endoscopic gastrostomy. Endoscopy 2020; 52: E187-E188
    Article in Thieme ConnectPubMedGoogle Scholar
  • 48 Singh D, Laya AS, Vaidya OU. et al. Risk of bleeding after percutaneous endoscopic gastrostomy (PEG). Dig Dis Sci 2012; 57: 973-980
    CrossrefPubMedGoogle Scholar
  • 49 Schrag SP, Sharma R, Jaik NP. et al. Complications related to percutaneous endoscopic gastrostomy (PEG) tubes. A comprehensive clinical review. J Gastrointest Liver Dis 2007; 16: 407-418
    PubMedGoogle Scholar
  • 50 Toussaint E, Van Gossum A, Ballarin A. et al. Enteral access in adults. Clin Nutr 2015; 34: 350-358
    CrossrefPubMedGoogle Scholar
  • 51 Casper M, Lammert F. How to improve success rates of endoscopic management for buried bumper syndrome. QJM 2018; 111: 467-472
    CrossrefPubMedGoogle Scholar
  • 52 Mueller-Gerbes D, Hartmann B, Lima JP. et al. Comparison of removal techniques in the management of buried bumper syndrome: a retrospective cohort study of 82 patients. Endosc Int Open 2017; 5: E603-E607
    Article in Thieme ConnectPubMedGoogle Scholar
  • 53 Costa D, Despott EJ, Lazaridis N. et al. Minimally invasive endoscopic management of buried bumper syndrome by use of a novel dedicated resection device. VideoGIE 2019; 4: 366-368
    CrossrefPubMedGoogle Scholar
  • 54 Heinrich H, Gubler C, Valli PV. Over-the-scope-clip closure of long lasting gastrocutaneous fistula after percutaneous endoscopic gastrostomy tube removal in immunocompromised patients: A single center case series. World J Gastrointest Endosc 2017; 9: 85-90
    CrossrefPubMedGoogle Scholar
  • 55 Gay-Chevallier S, Lupu A, Rivory J. et al. Closure of non-healing gastrocutaneous fistula after percutaneous endoscopic gastrostomy by endoscopic submucosal dissection and over-the-scope clip. Endoscopy 2019; 51: E125-E126
    Article in Thieme ConnectPubMedGoogle Scholar
  • 56 Brindley JH, Yip B, Vlachou E. et al. Successful endoscopic closure of a gastrocutaneous fistula using a “Padlock Clip.”. Endoscopy 2016; 48 (Suppl. 01) E115-E116
    Article in Thieme ConnectPubMedGoogle Scholar
  • 57 Galtieri PA, Auriemma F, Maselli R. et al. Omental patch for closure of a cecal perforation during endoscopic resection of a laterally spreading tumor. Endoscopy 2019; 51: E237-E238
    Article in Thieme ConnectPubMedGoogle Scholar
  • 58 Anderloni A, Bianchetti M, Mangiavillano B. et al. Successful endoscopic closure of iatrogenic duodenal perforation with the new Padlock Clip. Endoscopy 2017; 49 (Suppl. 01) E58-E59
    Article in Thieme ConnectPubMedGoogle Scholar
  • 59 Storm AC, Abu Dayyeh BK. Endoscopic sleeve gastroplasty for obesity: defining the risk and reward after more than 1600 procedures. Gastrointest Endosc 2019; 89: 1139-1140
    CrossrefPubMedGoogle Scholar
  • 60 Hedjoudje A, Abu Dayyeh BK, Cheskin LJ. et al. Efficacy and safety of endoscopic sleeve gastroplasty: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2020; 18: 1043-1053.e4
    Google Scholar
  • 61 Sharaiha RZ, Hajifathalian K, Kumar R. et al. Five-year outcomes of endoscopic sleeve gastroplasty for the treatment of obesity. Clin Gastroenterol Hepatol 2021; 19: 1051-1057.e2
    CrossrefPubMedGoogle Scholar
  • 62 Betzel B, Drenth JPH, Siersema PD. Adverse events of the duodenal-jejunal bypass liner: a systematic review. Obes Surg 2018; 28: 3669-3677
    CrossrefPubMedGoogle Scholar
  • 63 Hill C, El Zein M, Agnihotri A. et al. Endoscopic sleeve gastroplasty: the learning curve. Endosc Int Open 2017; 5: E900-E904
    Article in Thieme ConnectPubMedGoogle Scholar
  • 64 Saumoy M, Schneider Y, Zhou XK. et al. A single-operator learning curve analysis for the endoscopic sleeve gastroplasty. Gastrointest Endosc 2018; 87: 442-447
    CrossrefPubMedGoogle Scholar
  • 65 Sharaiha RZ, Kumta NA, Saumoy M. et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol 2017; 15: 504-510
    CrossrefPubMedGoogle Scholar
  • 66 Mahawar KK, Himpens JM, Shikora SA. et al. The first consensus statement on revisional bariatric surgery using a modified Delphi approach. Surg Endosc 2020; 34: 1648-1657
    CrossrefPubMedGoogle Scholar
  • 67 Kermansaravi M, Davarpanah Jazi AH, Shahabi Shahmiri S. et al. Revision procedures after initial Roux-en-Y gastric bypass, treatment of weight regain: a systematic review and meta-analysis. Updates Surg 2021; 73: 663-678
    CrossrefPubMedGoogle Scholar
  • 68 Tran DD, Nwokeabia ID, Purnell S. et al. Revision of Roux-en-Y gastric bypass for weight regain: a systematic review of techniques and outcomes. Obes Surg 2016; 26: 1627-1634
    CrossrefPubMedGoogle Scholar
  • 69 Petchers A, Walker A, Bertram C. et al. Evaluation of endoscopic gastrojejunostomy revision following Roux-en-Y gastric bypass for treatment of dumping syndrome. Gastrointest Endosc 2022; 96: 639-644
    CrossrefPubMedGoogle Scholar
  • 70 Stier C, Chiappetta S. Endoluminal revision (OverStitch(TM), Apollo Endosurgery) of the dilated gastroenterostomy in patients with late dumping syndrome after proximal Roux-en-Y gastric bypass. Obes Surg 2016; 26: 1978-1984
    CrossrefPubMedGoogle Scholar
  • 71 Tsai C, Steffen R, Kessler U. et al. Short-term outcomes of endoscopic gastro-jejunal revisions for treatment of dumping syndrome after Roux-En-Y gastric bypass. Surg Endosc 2020; 34: 3626-3632
    CrossrefPubMedGoogle Scholar
  • 72 Coblijn UK, Karres J, de Raaff CAL. et al. Predicting postoperative complications after bariatric surgery: the Bariatric Surgery Index for Complications, BASIC. Surg Endosc 2017; 31: 4438-4445
    CrossrefPubMedGoogle Scholar
  • 73 Williams D, Law R, Pullyblank AM. Colorectal stenting in malignant large bowel obstruction: the learning curve. Int J Surg Oncol 2011; 2011: 917848
    PubMedGoogle Scholar
  • 74 ASGE Technology Committee, Goodman AJ, Melson J. et al. Endoscopic simulators. Gastrointest Endosc 2019; 90: 1-12
    CrossrefPubMedGoogle Scholar
  • 75 Sedlack RE. The state of simulation in endoscopy education: continuing to advance toward our goals. Gastroenterology 2013; 144: 9-12
    CrossrefPubMedGoogle Scholar
  • 76 Desilets DJ, Banerjee S, Barth BA. et al. Endoscopic simulators. Gastrointest Endosc 2011; 73: 861-867
    CrossrefPubMedGoogle Scholar
  • 77 Leung JW, Wang D, Hu B. et al. A head-to-head hands-on comparison of ERCP mechanical simulator (EMS) and ex-vivo Porcine Stomach Model (PSM). J Interv Gastroenterol 2011; 1: 108-113
    PubMedGoogle Scholar
  • 78 Ekkelenkamp VE, Koch AD, de Man RA. et al. Training and competence assessment in GI endoscopy: a systematic review. Gut 2016; 65: 607-615
    Google Scholar
  • 79 Spota A, Laracca GG, Perretta S. Training in bariatric and metabolic endoscopy. Ther Adv Gastrointest Endosc 2020; 13: 2631774520931978
    CrossrefPubMedGoogle Scholar
  • 80 Jorgensen JE, Elta GH, Stalburg CM. et al. Do breaks in gastroenterology fellow endoscopy training result in a decrement in competency in colonoscopy?. Gastrointest Endosc 2013; 78: 503-509
    Google Scholar
  • 81 Ward ST, Hancox A, Mohammed MA. et al. The learning curve to achieve satisfactory completion rates in upper GI endoscopy: an analysis of a national training database. Gut 2017; 66: 1022-1033
    Google Scholar
  • 82 Ward ST, Mohammed MA, Walt R. et al. An analysis of the learning curve to achieve competency at colonoscopy using the JETS database. Gut 2014; 63: 1746-1754
    Google Scholar
  • 83 Wani S, Keswani R, Hall M. et al. A prospective multicenter study evaluating learning curves and competence in endoscopic ultrasound and endoscopic retrograde cholangiopancreatography among advanced endoscopy trainees: The Rapid Assessment of Trainee Endoscopy Skills Study. Clin Gastroenterol Hepatol 2017; 15: 1758-1767.e11
    CrossrefPubMedGoogle Scholar
  • 84 Siau K, Dunckley P, Valori R. et al. Changes in scoring of Direct Observation of Procedural Skills (DOPS) forms and the impact on competence assessment. Endoscopy 2018; 50: 770-778
    Google Scholar
  • 85 Siau K, Dunckley P, Feeney M. et al. ERCP assessment tool: evidence of validity and competency development during training. Endoscopy 2019; 51: 1017-1026
    Article in Thieme ConnectPubMedGoogle Scholar
  • 86 Gavin DR, Valori RM, Anderson JT. et al. The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK. Gut 2013; 62: 242-249
    Google Scholar
  • 87 Mehta T, Dowler K, McKaig BC. et al. Development and roll out of the JETS e-portfolio: a web based electronic portfolio for endoscopists. Frontline Gastroenterol 2011; 2: 35-42
    Google Scholar
  • 88 Ekkelenkamp VE, Koch AD, Rauws EAJ. et al. Competence development in ERCP: the learning curve of novice trainees. Endoscopy 2014; 46: 949-955
    Article in Thieme ConnectPubMedGoogle Scholar
  • 89 Siau K, Hawkes ND, Dunckley P. Training in Endoscopy. Curr Treat Options Gastroenterol 2018; 16: 345-361
    CrossrefPubMedGoogle Scholar