Advances in Pancreatic Endoscopy

Charles J. Lightdale, MD, Consulting Editor

“Risky Business” is a title that springs to mind when considering an issue of the Gastrointestinal Endoscopy Clinics of North America on the subject of “Endoscopy in Pancreatic Diseases.” The pancreas is such a complex and “touchy” organ, that for years, gastrointestinal endoscopists have tended to avoid the risks of diagnosing and treating pancreatic diseases. Times have changed! Interventional endoscopists have learned to approach the pancreas with a strategy of “treat it with respect” rather than “avoid the pancreas at all costs.” Using improved instruments and new understanding of pancreatic pathophysiology, these endoscopists have harnessed endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography to improve diagnosis and treatment of many pancreatic diseases: acute and chronic, inflammatory, and neoplastic. Patients with pancreatic diseases have gained tremendous benefit from their efforts. Of course, the management of pancreatic diseases takes a multispecialty effort, and for endoscopists, the classic Kenny Rogers anthem: “know when to hold ‘em, know when to fold ‘em,” is particularly apt.

I feel so fortunate that the great gastrointestinal endoscopist from Minnesota, Martin Freeman, agreed to be guest editor for this issue of Gastrointestinal Endoscopy Clinics of North America on pancreatic diseases. Dr Freeman has an extraordinary grasp of this evolving field and has gathered an outstanding group of experts to provide a comprehensive coverage of pancreatic diseases and the possibilities and limitations of endoscopic interventions. I understand that sweetbreads are not for every taste, but for gastroenterologists in general, and for radiologists and surgeons, and especially for pancreatologists and interventional endoscopists, this issue is made to order.

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