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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.
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 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.