83 Impact of a Surgical Registrar Training in Endoscopic Retrograde Cholangiopancreatography (ERCP) on Clinical Outcomes and Complication Rates in a District General Hospital

Abstract Aim ERCP is a technically challenging procedure with high complication rates. Evidence of impact of trainee involvement on ERCP outcomes and complications is limited. Our audit evaluated whether involvement of a surgical trainee influenced cannulation rate of the native papilla, stone clearance, stricture stenting and occurrence of complications. Method A retrospective analysis was conducted of all ERCP procedures performed between April 2024 and April 2025 at the Royal Hampshire County Hospital. Primary outcomes included the KPIs described above. Secondary outcomes included the incidence of complications. Statistical analysis was performed using Fisher’s exact test. Results A total of 164 ERCPs were analysed (83 female; median age 71.5), of which 63 involved a trainee. Cannulation of the native papilla was successful in 88% of trainee cases and 94% without (p = 0.33; OR 0.49, 95% CI: 0.11–2.04). Stone clearance for stones <10 mm was 94% with a trainee vs. 93% without (p = 1.00; OR 1.27, 95% CI: 0.17–14.74). Stricture stenting was successful in 80% of trainee cases vs. 100% without (p = 0.076; OR 0.00, 95% CI: 0.00–1.81). Pancreatitis occurred in 6% of trainee cases vs. 5% without (p = 0.73; OR 1.30, 95% CI: 0.25–6.31). Bleeding occurred in one case per group (p = 1.00). Cholangitis occurred in two cases without a trainee and none with (p = 0.52). Conclusions Trainee involvement in ERCP did not significantly impact any of the KPIs or complication rates. These findings support training of surgical registrars in ERCP in a DGH setting.