Nabi Z. et al., 2025: Role of endoscopic retrograde cholangiopancreatography in pancreatitis.

Peter Alken

Thursday, 12 June 2025

451 Hits

Zaheer Nabi 1, Duvvur Nageshwar Reddy 1
1Asian Institute of Gastroenterology, Hyderabad 500082, India.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from mainly a diagnostic tool to a treatment method, thanks to newer noninvasive techniques like magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS). This paper looks at how ERCP is used to treat conditions such as acute gallstone pancreatitis, pancreas divisum (PD), sphincter of Oddi dysfunction (SOD), and chronic pancreatitis (CP). For acute gallstone pancreatitis, early ERCP to reduce severity or mortality is now questioned, except when there is cholangitis or ongoing bile duct blockage. For patients with recurring acute pancreatitis due to PD, endoscopic treatment aims to lower duct pressure, but there is not enough strong evidence to support its long-term success. In SOD cases, recent research suggests being more careful with endoscopic sphincterotomy. ERCP plays a clearer role in CP by helping to manage duct stones and strictures in suitable patients. The rising use of pancreatoscopy-assisted lithotripsy as an alternative to ESWL is also discussed.

J Can Assoc Gastroenterol. 2025 Feb 21;8(Suppl 2):S74-S80. doi: 10.1093/jcag/gwae043. eCollection 2025 Mar. PMID: 39990510 Free PMC article

Comments 1

Peter Alken on Thursday, 12 June 2025 11:00

As a reviewer I enjoyed reading this paper - despite being a urologist - because of its clear statements on therapeutic ERCP. It parallels some of the problems we have with “reconstructive” endourological procedures.
A third of the 74 references has been published within the last 6 years.

Peter Alken

As a reviewer I enjoyed reading this paper - despite being a urologist - because of its clear statements on therapeutic ERCP.  It parallels some of the problems we have with “reconstructive” endourological procedures.
A third of the 74 references has been published within the last 6 years.

Peter Alken
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