Published online Nov 16, 2014. doi: 10.4253/wjge.v6.i11.513
Revised: October 10, 2014
Accepted: October 23, 2014
Published online: November 16, 2014
When endoscopic retrograde cholangio-pancreatography fails to decompress the pancreatic or biliary system, alternative interventions are required. In this situation, endosonography guided cholangio-pancreatography (ESCP), percutaneous radiological therapy or surgery can be considered. Small case series reporting the initial experience with ESCP have been superseded by comprehensive reports of large cohorts. Although these reports are predominantly retrospective, they demonstrate that endoscopic ultrasound (EUS) guided biliary and pancreatic interventions are associated with high levels of technical and clinical success. The procedural complication rates are lower than those seen with percutaneous therapy or surgery. This article describes and discusses data published in the last five years relating to EUS-guided biliary and pancreatic intervention.
Core tip: When endoscopic retrograde cholangiopancreatography fails or is not technically possible, endosonography guided cholangiopancreatography (ESCP) should be considered as the next potential intervention when the technical expertise is available. The increasing volume and quality of literature demonstrates that rendezvous procedures facilitated using ESCP are efficacious and safe. Other interventions are associated with greater complication rates and may be best undertaken only after multi-disciplinary discussion.