The substitution of endoscopic ultrasonography for endoscopic retrograde cholangio-pancreatography: implications for service development and training.
Diagnostic indications of endoscopic retrograde cholangio-pancreatography (ERCP) have not completely disappeared. But the substitution of this examination by endoscopic ultrasonography (EUS) in the work-up of biliary and pancreatic diseases is supported by EUS's reliability and cost-effectiveness. In the future EUS will be challenged by magnetic resonance cholangiopancreatography (MRCP), when easily available. Therefore, the choice between EUS, MRCP and ERCP will become simplified: MRCP as the first option for diagnosis, EUS in doubtful cases needing sampling for pathology and ERCP as a therapeutic alternative to some surgical procedures.
Sahel
José
J
Department of Gastroenterology and Hepatology, Hôpital Sainte Marguerite, Marseille, France. jose.sahel@ap-hm.fr
Barthet
Marc
M
Gasmi
Mohamed
M
D001649:Bile Duct Diseases / Q000175:diagnosis; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D002758:Cholangiography / Q000379:methods* / Q000639:trends; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000639:trends; D003362:Cost-Benefit Analysis / Q000191:economics; D004502:Education, Medical, Continuing / Q000379:methods; D019160:Endosonography / Q000191:economics / Q000639:trends*; D006801:Humans; D007858:Learning; D008279:Magnetic Resonance Imaging; D010182:Pancreatic Diseases / Q000175:diagnosis*; D015203:Reproducibility of Results