臨牀消化器内科 Vol.27 No.12(9)


特集名 消化器内視鏡トレーニングのあり方
題名 ERCPの卒後教育
発刊年月 2012年 11月
著者 玉田 喜一 自治医科大学付属病院消化器肝臓内科
著者 牛尾 純 自治医科大学付属病院消化器肝臓内科
著者 和田 伸一 自治医科大学付属病院消化器肝臓内科
著者 冨山 剛 自治医科大学付属病院消化器肝臓内科
著者 畑中 恒 自治医科大学付属病院消化器肝臓内科
著者 菅野 健太郎 自治医科大学付属病院消化器肝臓内科
【 要旨 】 かつては胃の生検にも側視鏡が使われていたが,最近の研修医は側視鏡を使う機会がない.ERCPを指導するうえでもっとも大切なことの一つは,直視鏡と側視鏡の違いを十分に教えることである.スムースな乳頭への到達,乳頭の正面視,適切なカニュレィションの順に教える必要がある.臨床例だけでなく,プラスチックモデルなどを用いた理論的な指導も大切である.
Theme Training System for Gastrointestinal Endoscopy
Title ERCP Training for Residents
Author Kiichi Tamada Department of Gastroenterology and Hepatology, Jichi Medical University
Author Jun Ushio Department of Gastroenterology and Hepatology, Jichi Medical University
Author Shinichi Wada Department of Gastroenterology and Hepatology, Jichi Medical University
Author Takeshi Tomiyama Department of Gastroenterology and Hepatology, Jichi Medical University
Author Hisashi Hatanaka Department of Gastroenterology and Hepatology, Jichi Medical University
Author Kentaro Sugano Department of Gastroenterology and Hepatology, Jichi Medical University
[ Summary ] Initially, during training of practitioners for endoscopic retrograde cholangiopancreatography (ERCP), many trainees cannot deal with side-viewing duodenoscopes, although they can use forward-viewing gastroscopes. In this paper, we describe a teaching program used to train residents who have not been exposed to side-viewing duodenoscopes. During training, the smooth introduction of the duodenoscope into the papilla of Vater, appropriate viewing of the papilla of Vater, and observation of deep cannulation in the bile duct are essential techniques which must be learned. Simulators can be used for training beginners to understand the specifics of side-viewing duodenoscopes. Hands-on simulator work may supplement clinical experience provided by training programs.
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