Abstract

Aims: This study aimed whether the companionship of the gastroenterology fellowships to operators performing high-volume ERCP, would adversely affect the safety and success of the procedure.
 Methods: This retrospective observational study included 964 patients with naïve papilla who underwent ERCP between February 2019 and May 2022. Procedures with fellowship involvement were compared with procedures performed only by the expert operator in terms of cannulation success, procedure time, cannulation time, unintended PD cannulation, difficult cannulation, cannulation techniques, and post-procedure adverse events. 
 Results: The two groups were similar in terms of procedure difficulty, successful cannulation in the first session, overall successful canulation, unintended PD cannulation, difficult cannulation rates, and cannulation techniques. The median procedure time was significantly higher in the fellowship involvement group compared to the other group (p=0.008). There was no difference between the two groups in terms of adverse events after the procedure (p>0.05). Procedure difficulty were found an independent risk factor of adverse events in the multivariate analysis (Odds ratio: 2.3; 95% Cl 1.4-3.6; p

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