Introduction Indeterminate biliary stricture (IDBS) remains one of the biggest challenges that pancreaticobiliary endoscopists face. While a strict definition of IDBS is frequently not adhered to in the literature, this term refers to biliary strictures with no overt mass on…
Introduction Chronic pancreatitis (CP) is an inflammatory condition that results in fibrosis causing destruction of pancreatic parenchyma and ducts. These permanent structural changes can lead to impairment of exocrine and endocrine function, biliary strictures, and may increase the chances of…
Introduction Pancreatic fluid collections (PFCs) and leaks develop due to main or secondary pancreatic ductal disruption caused by acute or chronic pancreatitis, trauma, or pancreatic surgery. PFCs include acute fluid collections, acute necrotic collections, pseudocysts, and walled-off necrosis. Most nonnecrotic…
Introduction Acute pancreatitis (AP) has an excellent prognosis if the severity is limited, and if the underlying cause can be identified and treated. However, AP may recur if the underlying causes are not eliminated or modified. Patients with recurrent AP…
Introduction Functional disorders of the biliary tree and pancreas are controversial topics, with insufficient scientific evidence to provide clear guidelines for clinical practice. This chapter attempts to summarize what is known, what is unclear, and what studies need to be…
Introduction The word cholangitis is a pathologic term that means “inflammation of bile ducts.” It is a broad term and does not imply any specific diagnosis. In clinical practice, cholangitis is defined on the basis of symptoms and signs of…
Introduction Accidental injuries of the bile ducts leading to biliary leaks and strictures may occur during any surgical procedure involving the biliary tract. However, the main causes of injury of the bile ducts at the present time are laparoscopic cholecystectomy…
Introduction Symptomatic gallbladder disease is one of the most common conditions encountered by the gastrointestinal endoscopist. It accounts for over 225,000 hospital discharges per year and over 2 billion health care dollars spent per year. Whereas gallbladder disease can manifest…
Introduction Endoscopic retrograde cholangiopancreatography (ERCP) has traditionally represented the optimal approach to the bile duct and the pancreatic duct. However, ERCP is not always successful because of the inability to achieve selective cannulation or because of inaccessibility of the papilla…
Introduction Endoscopic ultrasound (EUS) is a powerful technique that is integral to the management of many patients with biliary and pancreatic disease. EUS provides detailed images of the extrahepatic biliary tree and pancreas with very little risk to the patient,…