engleski

Low volume EUS center – start up

It is generally thought that endoscopic ultrasound is advanced endoscopic procedure reserved mainly for tertiary clinical centers. Undoubtedly it requires a level of training that exceeds general endoscopy and training under the supervision [1] as well as cognitive and technical skills [2]. It is reasonable to ask if a hospital with just over 50 pancreatobilliary procedures per year can handle endoscopic ultrasound, but our experience with great number of diagnostic procedures applied to patients from surrounding county hospitals made us think about a potential diagnostic niche. In our experience, to start up EUS in small volume center one should have willing workers, board approval, pool of patients, adequate training, continuous education, supervision under the EUS experts. First two conditions are satisfied at beginning, and adequate patient number should be achieved in years to come from surrounding areas which are too far from tertiary centers in Zagreb and Osijek. Croatian gastroenterology fellowship program teaches applicant to indicate the performance, knowing possibilities of intervention and limitations of endoscopic ultrasound and after completion of fellowship program gastroenterologist should be able to perform EUS of pancreatobiliary tract and Gl malignances [3]. Additional 6 months of intensive training under the supervision of experts are achieved, in which 150 procedures are performed under the supervision of experts. Further experience and educated cytologist are needed to establish competency in FNA practice, although 20 supervised FNA procedures were already performed. REFERENCES: [1]Hawkes RH, Fockens P, Varadarajulu S. Endosonography. Elsevier Saunders. 2015. [2]ASGE: Guidelines for credentialing and granting privileges for endoscopic ultrasound. Gastrointest Enclose. 54:811-814 2001 [3]http://www.propisi.hr/print.php?id=8228

endoscopic ultrasound ; general hospital

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