ERCP by laparoscopic transgastric access and cholecystectomy at the same time in a patient with gastric bypass who was seen with choledocholithiasis.

摘要

Our recent article published in Gastrointestinal En-doscopy, "Colonoscopy Training in Gastroenterology Fellowships: Determining Competence,"1 revealed that colonoscopic competency requires at least 500 observed colonoscopies to ensure >90% independence in all trainees. A second common measure of quality colonoscopy is that of a consistently high adenoma detection rate. Our findings1 and a study by Rogart et al2 demonstrated that the adenoma detection rate in colonoscopies performed by fellows in training was high and maintained throughout the 3 successive years of fellowship. In comparison, a study by Peters et al3 found a low adenoma detection rate in the first year of fellowship, with an increase in adenoma detection with each subsequent year of training. Our study suggests that a consistent adenoma detection rate across 3 years of training reflects the standardized nature of our trainee colonoscopy instruction program in which fellows are observed and evaluated for 100% of all cases from start to finish.