Dilated Bile Duct Defining Dilated Bile Ducts There is no consensus definition for what constitutes a dilated bile duct. Rather, it is important to understand that the definition is contextual and depends on the site of measurement, the imaging modality…
Anomalies of the biliary and pancreatic ducts are commonly encountered during endoscopic retrograde cholangiopancreatography (ERCP) and are important to both surgeons and gastroenterologists. This chapter reviews the diagnosis, clinical relevance, and therapy of these variants. Ampullary Anomalies Ectopic Major Papilla…
Endoscopic retrograde cholangiopancreatography (ERCP) was first described in 1968 (see Chapter 1 ). Despite being technically challenging because of the limited range of available endoscopes and accessories at that time, it became an important modality for diagnostic evaluation of the…
Overview Endoscopic ultrasonography (EUS) was first introduced in the 1980s and has since become a cornerstone of endoscopic diagnosis of pancreaticobiliary disease, tissue acquisition via fine-needle aspiration (FNA), and staging of gastrointestinal malignancy. As experience with directed needle access into…
Endoscopic ultrasonography (EUS) has gradually replaced many percutaneous image-guided interventions, such as tissue sampling of pancreatic tumors. Similarly, EUS-guided biliary therapeutics mirror percutaneous intervention on the biliary tract. Three anatomic structures can be targeted for biliary drainage under EUS guidance:…
Endoscopic retrograde cholangiopancreatography (ERCP) is generally considered the technically most difficult procedure in gastrointestinal (GI) endoscopy because of the complex maneuvers necessary to gain ductal access and perform therapies within the bile duct or pancreas. Altering the upper GI tract…
Pancreaticobiliary diseases such as choledocholithiasis and gallstone pancreatitis during pregnancy are challenging to manage because of increased risk to both the mother and fetus. Physiologic alterations during pregnancy, such as weight gain and hormonal changes, increase the risk of cholelithiasis.…
Endoscopic retrograde cholangiopancreatography (ERCP) was introduced into pediatric medicine in the late 1970s and is now routinely used for the diagnosis and treatment of biliary tract and pancreatic diseases in children throughout the world. With the advent of high-quality magnetic…
The concept of confocal microscopy was first patented in 1957. Since then, this technology has been used with much success in the laboratory, and more recently this has translated into use in various clinical settings, first described in the field…
Historically, cholangioscopy was performed with a fiberoptic mother (large-caliber duodenoscope) and daughter (cholangioscope) system requiring two endoscopists, two light sources, and two video monitors, if the endoscopy unit was fortunate enough to have two video cameras to interface with the…