EUS and ERCP: brothers in arms

摘要

With the advent of minimally invasive endoscopic procedures during the 1970s, ERCP has become the primary method of diagnosing and treating many patients with pan-creatobiliary disease (PBD). However, this role was later challenged by the introduction of less-invasive procedures such as high-end US, helical CT scanning, EUS, and finally magnetic resonance imaging (MRI) in clinical gastroenterol-ogy during the past 2 decades. These techniques have added a new dimension in the diagnosis of pancreatic and biliary diseases, leaving the more invasive ERCP procedures as primary "therapeutic" instruments for the treatment of biliary and pancreatic obstruction. This development was rather logical and expected because purely diagnostic ERCP still carries a significant risk of acute pancreatitis in up to 1.5% to 5-0% of cases and a small, albeit distinct, potential for procedure-related death