RT Book, Section
A1 Lee, Linda S.
A1 Carr-Locke, David L.
A2 Greenberger, Norton J.
A2 Blumberg, Richard S.
A2 Burakoff, Robert
SR Print(0)
ID 55959934
T1 Chapter 35. Endoscopic Retrograde Cholangiopancreatography (ERCP)
T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176848-1
LK accessmedicine.mhmedical.com/content.aspx?aid=55959934
RD 2023/09/23
AB Endoscopic  retrograde  cholangiopancreatography  (ERCP)  (Figure  35–1)  is  a  combined  endoscopic  and  fluoroscopic  procedure  that  was  introduced  in  the  early  1970s  to  allow  access  to  the  biliary  and  pancreatic  ductal  systems  and  their  openings  at  the  major  and  minor  duodenal  papillae.  ERCP  has  evolved  from  a  purely  diagnostic  technique,  performed  by  a  few,  into  a  complex  set  of  procedures  integrating  diagnosis  and  therapy  for  a  wide  variety  of  pancreatobiliary  disorders  offered  in  all  major  medical  centers.  ERCP  requires  dedicated  training  in  order  to  acquire  the  range  of  techniques  that  include  endoscopic  papillectomy,  sphincter  of  Oddi  manometry,  biliary  sphincterotomy,  pancreatic  sphincterotomy,  stone  removal,  tissue  sampling,  placement  of  plastic  and  metallic  stents,  and  drainage  of  pancreatic  fluid  collections.  Although  it  has  become  a  highly  successful  therapeutic  modality,  ERCP  also  carries  an  overall  morbidity  of  7%  that  includes  pancreatitis  (4%),  hemorrhage  (1%),  cholangitis  (1%),  perforation  (0.5%),  and  death  (0.1%).  With  the  advent  of  magnetic  resonance  cholangiopancreatography  (MRCP)  (Figure  35–2)  which  safely  and  noninvasively  images  the  pancreatic  and  biliary  tracts,  the  need  for  purely  diagnostic  ERCP  has  appropriately  diminished  considerably  while  the  demands  for  therapy  have  grown.