Endoscopic Management of Biliary Disorders: Diagnosis and Therapy

Rajesh Krishnamoorthi; Andrew Ross

doi:10.1016/j.suc.2018.12.002

Endoscopic Management of Biliary Disorders: Diagnosis and Therapy

Surg Clin North Am. 2019 Apr;99(2):369-386. doi: 10.1016/j.suc.2018.12.002.

Authors

Rajesh Krishnamoorthi¹, Andrew Ross²

Affiliations

¹ Digestive Diseases Institute, Virginia Mason Medical Center, Seattle, WA 98101, USA.
² Digestive Diseases Institute, Virginia Mason Medical Center, Seattle, WA 98101, USA. Electronic address: Andrew.Ross@virginiamason.org.

PMID: 30846040
DOI: 10.1016/j.suc.2018.12.002

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic and therapeutic tool to a predominantly therapeutic tool. There is a limited role for diagnostic ERCP with widespread availability of magnetic resonance cholangiopancreatography and endoscopic ultrasound (EUS). Since its introduction, EUS evolved from a diagnostic imaging modality to one with combined diagnostic and therapeutic capabilities. Currently, ERCP remains the standard of care for biliary decompression. In future, it is possible that EUS guided transmural biliary drainage may replace ERCP for certain indications. Given the risk of adverse events related with these more invasive endoscopic procedures, a multidisciplinary team-based approach is recommended.

Keywords: Altered anatomy ERCP; Ampullary adenoma; Biliary disorders; ERCP; EUS; Endoscopic retrograde cholangiopancreatography; Endoscopic ultrasound.

Publication types

Review

MeSH terms

Biliary Tract Diseases / diagnostic imaging*
Biliary Tract Diseases / pathology
Biliary Tract Diseases / surgery*
Cholangiopancreatography, Endoscopic Retrograde*
Drainage
Endosonography*
Humans