Purpose Of review: The role of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) continues to mature. We will review the progress of pancreatobiliary endoscopy in the evaluation and treatment of benign and malignant pancreatobiliary diseases. Recent findings: First, minimizing contrast injection of the pancreas, wire-guided cannulation and prophylactic pancreatic stenting have been re-emphasized in recent studies as the most important endoscopic interventions that can lower the risk of post-ERCP pancreatitis. The role of preoperative ERCP in patients with jaundice secondary to pancreatic cancer was raised in a randomized trial; the widespread use of preoperative biliary drainage is now up for debate. The use of ERCP, intraoperative cholangiography, endoscopic ultrasound and magnetic resonance cholangiopancreatography in the evaluation of suspected common bile duct stones is discussed. We conclude by evaluating studies of fully covered, self-expandable metallic stents, with an emphasis on their potential use in benign biliary disease. Summary: Given the risk of complications and development of alternative imaging modalities, diagnostic ERCP is rarely indicated. However, therapeutic ERCP has been bolstered by advances such as fully covered metallic stents and cholangioscopy.
- endoscopic retrograde cholangiopancreatography
- pancreatic cancer
- pancreatic stent
- self-expandable metallic stent
ASJC Scopus subject areas
TY - JOUR
T1 - Advances in pancreatobiliary endoscopy
AU - Coté, Gregory A.
AU - Sherman, Stuart
PY - 2010/9
Y1 - 2010/9
N2 - Lippincott Williams & Wilkins.
AB - Lippincott Williams & Wilkins.
KW - cannulation
KW - endoscopic retrograde cholangiopancreatography
KW - pancreatic cancer
KW - pancreatic stent
KW - self-expandable metallic stent
UR - http://www.scopus.com/inward/record.url?scp=77955922622&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955922622&partnerID=8YFLogxK
U2 - 10.1097/MOG.0b013e32833d171f
DO - 10.1097/MOG.0b013e32833d171f
M3 - Article
VL - 26
SP - 429
EP - 435
JO - Current Opinion in Gastroenterology
JF - Current Opinion in Gastroenterology
SN - 0267-1379
IS - 5