Endoscopic ultrasound and percutaneous access for endoscopic biliary and pancreatic drainage after initially failed ERCP

Kapil Gupta, James S Mallery, David Hunter, Martin L Freeman

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations

Abstract

Although the success rates of endoscopie retrograde cholangiopancreatography (ERCP) in accessing the bile and pancreatic ducts are quite high, failure to achieve duct access still occurs. Options in these cases have traditionally included percutaneous access or open surgical intervention. A combination percutaneous and endoscopic approach (ie, rendezvous procedure) is often used in cases of failed biliary cannulation by ERCP and occasionally for pancreatic duct access. However, this technique often results in complications and is hampered by the difficulty in coordinating schedules between interventional radiologists and endoscopists and the lack of predictability of failed ERCP access. Several groups have described the use of endoscopic ultrasonography (EUS) in accessing the ducts in cases of failed ERCP. This technique has the potential to substantially reduce the need for a percutaneous or surgical approach in many cases. This article reviews the nonsurgical methods for accessing the biliary and pancreatic ducts after failure of ERCP as well as the current status and possible future applications of EUS-assisted drainage techniques.

Original languageEnglish (US)
Pages (from-to)22-37
Number of pages16
JournalReviews in Gastroenterological Disorders
Volume7
Issue number1
StatePublished - Dec 1 2007

Keywords

  • Bile duct
  • Endoscopic retrograde cholangiopancreatography
  • Endoscopic ultrasonography
  • Pancreatic duct
  • Rendezvous technique

Fingerprint Dive into the research topics of 'Endoscopic ultrasound and percutaneous access for endoscopic biliary and pancreatic drainage after initially failed ERCP'. Together they form a unique fingerprint.

Cite this