Endoscopic therapy of pancreatic disease

Endoscopic management of a variety of benign and malignant biliary tract diseases is now a well-established alternative to surgery. Similar techniques are beginning to be applied to the pancreas. Endoscopic therapy is now being utilized in the setting of acute pancreatitis, chronic pancreatitis, complications of pancreatitis, and pancreas divisum. In this review, we will analyze the current state of the art of these exciting new applications of endoscopy. Selection of appropriate candidates for the various treatment modalities appears important for optimal results of therapy. However, definite recommendations are difficult to make because there are few controlled studies, follow-up in most series is brief, and there are no comparison studies of endoscopic versus surgical therapy. At present, conservatism is the appropriate general rule in these therapeutic endeavors.