Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Endoscopic retrograde cholangiopancreatography (ERCP) has been a remarkable technological advance that has evolved over its nearly 50 years in the field of gastrointestinal endoscopy and has redefined the medical and surgical approach to patients with pancreatic and biliary tract diseases. Since its inception in 1968, the medical community has witnessed significant achievements by the pioneers in endoscopy who incrementally advanced ERCP techniques from their infancy to maturity. The infancy focused on diagnoses, the adolescence on therapies of common biliary tract diseases such as bile duct stones and malignant strictures, the early adulthood on therapy for diseases of the pancreas and prevention of pancreatitis, and now the mature adulthood focuses on continued refinement of techniques to make ERCP safer and more effective. The pioneers in the ERCP field are numerous and have played significant roles in developing new techniques and novel instrumentation, spearheaded innovative techniques to reduce adverse events, and effectively trained future generations of endoscopists to safely perform ERCP. We are now approaching a 50-year milestone, and as we look back, we can recall a journey in ERCP that has been enjoyable, exciting, and replete with enthusiastic innovation, and in the end has benefitted many patients ( Box 1.1 ). It would encompass an entire book to incorporate all of the important contributions made by the many ERCP endoscopists over the past 50 years. We apologize in advance to individuals who have advanced the field and are not mentioned in this brief summary of the history of ERCP.
Locating the ampulla
Biliary and pancreatic duct cannulation
Interpretation of cholangiography and pancreatography, identifying pathology
First reports of biliary sphincterotomy
Developing the instruments: balloon extraction of bile duct stones and stent placement
Refinement of accessories, improvements in radiographic imaging
Reporting adverse events of sphincterotomy
Biliary stent placement for obstructive jaundice and shift from palliative surgery
Introduction of the teaching head: “seeing is believing”
Acceptance of ERCP by the medical community
Management of CBD stones shifts from surgery to endoscopy
ERCP training gets its start for physicians and ERCP nurses
Basic threshold numbers for competence
More emphasis on advanced training
Endoscopic photography and videography: sharing images with others
Referring MDs, patients, and industry
Comparison of one procedure to another
Teaching and training
“Theater presentations” of ERCP
Therapies for pancreatic disorders: chronic pancreatitis, pseudocysts, and necrosis
Era of laparoscopic cholecystectomy and bile duct injuries
Safer sphincterotomy: monofilament wires and computer-regulated blended current
Self-expandable metallic stents
Complementary pancreaticobiliary techniques developed
Endoscopic ultrasonography (EUS) and magnetic resonance cholangiopancreatography (MRCP)
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here