Interventional Endoscopy in the Pancreatobiliary Tree

Since the advent of endoscopic retrograde cholangio‐pancreatography (ERCP) in 1970 and endoscopic sphincterotomy (EST) in 1974, there bas been rapid proliferation of endoscopic techniques for the diagnosis and therapy of benign and malignant biliary and pancreatic disorders. the ability to biopsy under direct vision, reliably obtain a pancreatogram, exclude other upper gastrointestinal disorders, and reexamine with ease, combined with the lack of hepatic puncture, bas given the endoscopic route an undeniable advantage over the percutaneous transhepatic route for these interventions. Although some have become routine procedures (EST for postcholecystectomy cholehocholithiasis; transhapillary stent insertion for inoperable biliary stenoses), the exact place of many of these interventions remains unclear, and the subject of prospective controlled studies where possible. This review attempts to give an overview of present and developing ERCP‐ and EST‐based diagnostic and interventive techniques and their application to the wide spectrum of pancreatobiliary diseases. Copyright © 1988, Wiley Blackwell. All rights reserved