Interventional endoscopy of the biliary and pancreatic ducts: current indications and methods

The use of interventional endoscopy of the biliary and pancreatic ducts has increased dramatically in recent years. Although choledocholithiasis is the most common reason for endoscopic treatment, other indications include pancreatolithiasis, cholangitis, biliary pancreatitis, papillary stenosis, sphincter of Oddi dysfunction, and benign or malignant ductal strictures. Endoscopic sphincterotomy is the cornerstone of therapeutic endoscopy and often precedes the use of balloon and basket stone extractors and placement of stents and endoprostheses. Other endoscopic methods include the use of lithotripsy, placement of drainage and infusion catheters, and coupling with percutaneous techniques. Radiologists need to be aware of the expanding indications and variety of endoscopic methods available for treating biliary and pancreatic disorders so that they can understand when the procedures are indicated.