Korean Society of Gastrointestinal Endoscopy

Endoscopic retrograde cholangiopancreatography (ERCP) training remains challenging. This study used 3D printing techniques to develop and optimize a portable ERCP training simulator and to implement basic and advanced practical techniques. Subsequently, we aimed to determine whether endoscopy trainees acquired proficiency in ERCP techniques and assess any improvements in their skill levels from using this model. An ERCP training model was generated using 3D printing techniques, including five distinct interchangeable and transparent ampullar–common bile duct (CBD) modules. A prospective study using this model was conducted with ten trainees. The technical success rate and examination times for duodenoscope insertion and biliary cannulation were evaluated. In addition, the successful plastic-stent insertion rate and trainee satisfaction were measured. The success rates for duodenoscopy, cannulation, and plastic stent insertion were 94, 100, and 92%, respectively. The mean satisfaction scores for duodenoscope insertion, cannulation, and plastic stent insertion were 4.4, 4.7, and 4.6 on a 5-point scale, respectively. Five attempts decreased the insertion time (R = − 0.591, P < 0.001) and cannulation time (R = − 0.424, P = 0.002). This ERCP-training silicon model is durable, simulates ERCP techniques easily, and helps trainees improve their ERCP techniques.

This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the upper gastrointestinal (UGI) tract. The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals between January and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016. UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions, 1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8-74) months. SELs were most frequently found in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients (28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The proportions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1-2 cm), 27% (2-3 cm), and 38% (≥3 cm). In gastric SELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs. The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed by EUS and clinical decisions without initial pathological confirmation.