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World J Gastrointest Endosc. Jun 16, 2010; 2(6): 212-222
Published online Jun 16, 2010. doi: 10.4253/wjge.v2.i6.212
Endosonography-guided cholangiopancreatography as a salvage drainage procedure for obstructed biliary and pancreatic ducts
Manuel Perez-Miranda, Carlos de la Serna, Pilar Diez-Redondo, Juan J Vila
Manuel Perez-Miranda, Carlos de la Serna, Pilar Diez-Redondo, Endoscopy Unit. Hospital Universitario Rio Hortega, Valladolid 47012, Spain
Juan J Vila, Endoscopy Unit, Gastroenterology Department, Hospital de Navarra, Pamplona 31008, Spain
Author contributions: Pérez-Miranda M, de la Serna C and Diez-Redondo P drafted this paper; and Vila JJ gave a critical revision.
Correspondence to: Manuel Perez-Miranda, MD, Endoscopy Unit, Hospital Universitario Rio Hortega, Av. Dulzaina, 2, Valladolid 47012, Spain.
Telephone: +34-983-420400 Fax: +34-983-331566
Received: January 18, 2010
Revised: May 25, 2010
Accepted: June 1, 2010
Published online: June 16, 2010

Endoscopic ultrasound allows transmural access to the bile or pancreatic ducts and subsequent contrast injection to provide ductal drainage under fluoroscopy using endoscopic retrograde cholangiopancreatography (ERCP)-based techniques. Differing patient specifics and operator techniques result in six possible variant approaches to this procedure, known as endosonography-guided cholangiopancreatography (ESCP). ESCP has been in clinical use for a decade now, with over 300 cases reported. It has become established as a salvage procedure after failed ERCP in the palliation of malignant biliary obstruction. Its role in the management of clinically severe chronic/relapsing pancreatitis remains under scrutiny. This review aims to clarify the concepts underlying the use of ESCP and to provide technical tips and a detailed step-by-step procedural description.

Keywords: Endosonography, Drainage, Endoscopy, Digestive system, Therapeutics, Endoscopic ultrasound, Endoscopic retrograde cholangiopancreatography