Grading the degree of difficulty of ERCP procedures.

procedures. It was modeled after rock climbing cliffs, in which climbs are rated on a numerical degree-of-difficulty scale, and the number does not depend on the climber. Originally, the ERCP difficulty grading scale ranged from 1 to 5, with 1 being a relatively easy ERCP procedure and 5 being a difficult ERCP procedure. A few years later, a committee from the American Society for Gastrointestinal Endoscopy (ASGE), of which I was a part, eliminated 2 of the grades, making the scale range from grade 1 to grade 3. AdvAnces in endoscopy