Endoscopic retrograde cholangiopancreatography: Current practice and future research

Area of Science:

• Gastroenterology
• Endoscopy
• Hepatology

Background:

• Endoscopic retrograde cholangiopancreatography (ERCP) has transitioned from diagnostic to therapeutic.
• Commonly used for choledocholithiasis, ERCP now manages pancreatic stones, strictures, and leaks.
• Technological advancements are crucial for improving ERCP outcomes.

Purpose of the Study:

• To review recent advancements in ERCP.
• To highlight innovations in infection prevention and quality improvement.
• To discuss new techniques for pancreaticobiliary access and disease management.

Main Methods:

• Review of recent literature on ERCP advancements.
• Focus on new technologies such as disposable duodenoscopes and endoscopic ultrasound (EUS).
• Discussion of techniques for complex cases, including altered anatomy and cholangioscopy/pancreatoscopy.

Main Results:

• Disposable duodenoscopes improve quality and prevent infections.
• Endoscopic ultrasound (EUS) facilitates direct bile duct access.
• Advanced techniques enable ERCP in surgically altered anatomy and for complex stone/stricture management.
• Cholangioscopy and pancreatoscopy are increasingly utilized for diagnosis and treatment.

Conclusions:

• ERCP has significantly evolved with technological and procedural innovations.
• These advancements improve safety, infection control, and therapeutic capabilities in hepatobiliary and pancreatic diseases.
• Future research should continue to explore and refine these techniques for optimal patient care.