title: Endosonography-guided cholangiopancreatography as a salvage drainage procedure for obstructed biliary and pancreatic ducts.
abstract: Endoscopic ultrasound allows transmural access to the bile or pancreatic ducts and subsequent contrast injection to provide ductal drainage under fluoroscopy using endoscopic retrograde cholangiopancreatography (ERCP)-based techniques. Differing patient specifics and operator techniques result in six possible variant approaches to this procedure, known as endosonography-guided cholangiopancreatography (ESCP). ESCP has been in clinical use for a decade now, with over 300 cases reported. It has become established as a salvage procedure after failed ERCP in the palliation of malignant biliary obstruction. Its role in the management of clinically severe chronic/relapsing pancreatitis remains under scrutiny. This review aims to clarify the concepts underlying the use of ESCP and to provide technical tips and a detailed step-by-step procedural description.
authors.affiliation: Manuel Perez-Miranda, Carlos de la Serna, Pilar Diez-Redondo, Endoscopy Unit. Hospital Universitario Rio Hortega, Valladolid 47012, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Perez-Miranda
authors.forename: Carlos
authors.initials: C
authors.lastname: de la Serna
authors.forename: Pilar
authors.initials: P
authors.lastname: Diez-Redondo
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Vila