Editorial
Copyright ©2010 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 14, 2010; 16(38): 4755-4761
Published online Oct 14, 2010. doi: 10.3748/wjg.v16.i38.4755
Role of endoscopic retrograde cholangiopancreatography in pancreatic diseases
Dimitrios K Christodoulou, Epameinondas V Tsianos
Dimitrios K Christodoulou, Epameinondas V Tsianos, 1st Division of Internal Medicine and Hepato-Gastroenterology Unit, Medical School of Ioannina - Greece, University Campus, GR 45110, Ioannina, Greece
Author contributions: Christodoulou DK contributed to conception and drafting of the article; Tsianos EV contributed to drafting the article and revising it critically; both authors approved the final version of the manuscript to be published.
Correspondence to: Epameinondas V Tsianos, MD, PhD, Professor of Medicine, 1st Division of Internal Medicine and Hepato-Gastroenterology Unit, Medical School of Ioannina - Greece, University Campus, GR 45110, Ioannina, Greece. etsianos@uoi.gr
Telephone: +30-26-51007500 Fax: +30-26-51007883
Received: April 23, 2010
Revised: June 18, 2010
Accepted: June 25, 2010
Published online: October 14, 2010
Abstract

Over the last 15 years, endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic tool to one that is primarily used to provide therapy. This development occurred first for biliary disorders and subsequently to a lesser extent for pancreatic diseases. Computed tomography, magnetic resonance imaging, magnetic resonance cholangiopancreatography and endoscopic ultrasonography suggest a diagnosis in the majority of patients with pancreatic diseases today and can help physicians and patients avoid unnecessary ERCP. However, a selected number of patients with pancreatic diseases may benefit from pancreatic endotherapy and avoid complex surgery and chronic use of medications. Pancreatic sphincterotomy, pancreatic stenting and pancreatic cyst drainage are some of the most effective and challenging endoscopic pancreatic interventions and should be performed with caution by expert therapeutic endoscopists. There has been a paucity of randomized studies investigating endoscopic techniques in comparison with surgery and medical therapy for the treatment of most benign and malignant pancreatic disorders due to the limited number of patients and the expertise required to attempt these procedures.

Keywords: Endoscopic retrograde cholangiopancreatography; Pancreas; Pancreatic disease; Pancreatic endotherapy; Therapeutic endoscopy