The sphincter of Oddi (SO) is a complex smooth muscle structure surrounding the terminal common bile duct, main pancreatic duct, and the common channel, when present ( Fig. 16.1 ). The high-pressure zone generated by the sphincter ranges from 4…
The first and often most important step in endoscopic retrograde cholangiopancreatography (ERCP) is successful deep cannulation of the desired duct, most commonly the common bile duct (CBD). Although it remains the first step, cannulation of the CBD can be challenging…
Despite advances in imaging and device technology over the past decade, endoscopic retrograde cholangiopancreatography (ERCP) continues to be technically challenging and subject to adverse events and procedure failure. To some extent this is accounted for by the knowledge that among…
Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most dangerous procedures that gastroenterologists perform regularly; adverse events occur in at least 5% of cases, and lawsuits are common. However, the likelihood of being sued (as well as the success of…
Endoscopic retrograde cholangiopancreatography (ERCP) is a technically demanding procedure that requires considerable endoscopic skill. It is associated with the highest adverse event rates of any endoscopic procedure. It is important that endoscopists with competency in ERCP are granted privileges to…
Electrosurgery Electrosurgery harnesses electricity with the intention of creating various thermal effects to achieve resection, incision, hemostasis, and devitalization of target tissues. The therapeutic basis of all electrosurgery is the production of thermal energy at the cellular level, typically as…
The planning required for successful endoscopic retrograde cholangiopancreatography (ERCP) is more complex than that for routine endoscopic procedures and requires the synthesis of multiple variables. Preparation for ERCP involves preparing not just the patient, but also the endoscopist, the endoscopy…
Endoscopic retrograde cholangiopancreatography (ERCP) continues to be one of the most technically challenging endoscopic procedures. Training in ERCP requires the mastery of a broad skill set for this procedure to be performed safely and effectively, given the higher rate and…
Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic modality to a primarily therapeutic procedure for pancreatic and biliary disorders. ERCP alone or with associated biliary and pancreatic instrumentation and therapy can cause a variety of short-term adverse events, including…
The appropriate use of endoscopic retrograde cholangiopancreatography (ERCP), as well as avoidance of this procedure when it is contraindicated or when there are alternative diagnostic procedures, is a quality issue for gastrointestinal (GI) endoscopists. The Standards of Practice guidelines of…