Therapeutic and Advanced ERCP Is Rapidly Progressing

From the first published report of endoscopic cannulation of the ampulla of Vater by W.S. McCune and colleagues in 1968, and the remarkable demonstrations of Oi and colleagues using improved duodenoscopes in 1970, endoscopic retrograde cholangiopancreatography (ERCP) has made amazing progress. As radiological imaging (primarily computed tomography and magnetic resonance imaging) advanced in parallel, and special endoscopic ancillary tools for ERCP were developed, the focus has shifted strongly from mainly diagnostic to therapeutic uses for ERCP. During ERCP, the combined utilization of endoscopy and fluoroscopy to access and operate within the ductal systems of the liver and the pancreas has proven to be extremely powerful. Arguably, the most difficult and yet the most exciting of all procedures in gastrointestinal endoscopy today, therapeutic ERCP, has assumed a major role in managing diseases of the biliary tree and the pancreas.

I am particularly grateful that Michel Kahaleh, an internationally recognized authority in ERCP, is the guest editor for this issue of the Gastrointestinal Endoscopy Clinics of North America on the subject of “Therapeutic and Advanced Endoscopic Retrograde Cholangiopancreatography.” Dr Kahaleh brings his knowledge, skills, experience, and energy to this topic and has enlisted an extraordinary group of fellow experts to participate. Everyone who performs ERCP, wrapped in lead from neck to knees, probing the ampulla of Vater through an endoscope while looking at both endoscopic and fluoroscopic screens, should read this issue, which highlights the present and rapidly developing future of this fascinating procedure.

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