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Endoscopic Retrograde Cholangiopancreatography (ERCP)

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Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is used to diagnose and intervene on a variety of pancreaticobiliary pathologies. It is a mainstay of therapy for cholangitis, choledocholithiasis, initial treatment of pancreatic and biliary strictures, and several post-cholecystectomy indications. Advances in technique and equipment now enable targeted biopsies and stone treatment under direct endoscopic visualization. ERCP can be safely performed in patients with altered foregut anatomy by skilled teams using modified equipment and techniques, including transgastric approaches in patients after roux-en-y gastric bypass. Despite expanding indications and increased procedural sophistication, operators should remain mindful of the underlying principles of careful endoscopic access, controlled cannulation and sphincterotomy, and image-guided intervention. Procedural risks, most notably post-ERCP pancreatitis, should be carefully weighed against the numerous potential benefits of ERCP for minimally invasive diagnosis and treatment of disorders of the hepatobiliary and pancreatic ductal systems.

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Authors and Affiliations

  1. Division of General Surgery, Vanderbilt University Medical Center, D-5203 Medical Center North, VUMC. 1161 21st Ave South, Nashville, TN, 37232, USA

    Kristy L. Kummerow M.D. & Benjamin K. Poulose M.D., M.P.H.

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  1. Kristy L. Kummerow M.D.
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  2. Benjamin K. Poulose M.D., M.P.H.
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Correspondence to Kristy L. Kummerow M.D. or Benjamin K. Poulose M.D., M.P.H. .

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  1. Cleveland Clinic, Section of Surgical Endoscopy, Cleveland, Ohio, USA

    Matthew Kroh

  2. The Oregon Clinic, Division of Gastrointestinal Surgery, Portland, Oregon, USA

    Kevin M. Reavis

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Kummerow, K.L., Poulose, B.K. (2016). Endoscopic Retrograde Cholangiopancreatography (ERCP). In: Kroh, M., Reavis, K. (eds) The SAGES Manual Operating Through the Endoscope. Springer, Cham. https://doi.org/10.1007/978-3-319-24145-6_19

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