Fundamentals of ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) was first described in 1968 and we have recently celebrated the 30th anniversary of endoscopic sphincterotomy. This diagnostic and therapeutic modality has impacted significantly in the management of patients with many different benign and malignant pancreatico-biliary problems. A successful ERCP requires the coordination and cooperation of a dedicated and committed team of endoscopists, nurses, and assistants, as well as an organized and functioning unit. It takes many years to learn, and repeated practice, in order to master the skill of ERCP and to do it safely. It is important to understand the indications, contraindications, limitations, and complications of individual procedures when offering ERCP to our patients. Although successful ERCP has replaced surgery as a treatment option for some difficult pancreatico-biliary diseases, we have also seen problems and complications arising as a result of endoscopic treatment. Prospective collection of data and selected randomized controlled studies with long-term follow-up are necessary to evaluate the true value of this technology in the overall care of our patients.