Biliary tract: PDF OnlyNandi Partha S. MD; Scheiman, James M. MDCurrent Opinion in Gastroenterology: September 1997 - p 432-438 Buy Abstract Endoscopic retrograde cholangiopancreatography (ERCP) is a well-established technique for both the diagnosis and treatment of biliary and pancreatic disorders. The major drawbacks to the widespread application of this procedure include its requirement for an experienced endoscopist and the inherent complication risk, most notably pancreatitis. Performance of endoscopic sphincterotomy has emerged as a major risk factor for post-ERCP pancreatitis, leading to concerns regarding the selective application of the procedure in cases of suspected biliary pancreatitis and its timing in relation to laparoscopic cholecystectomy. There is no clear consensus regarding the selective use of ERCP in both clinical circumstances, but recent data support the value of early ERCP when there is a strong clinical suspicion of biliary stone disease or cholangitis. Although competing imaging modalities such as magnetic resonance cholangiopancreatography and endoscopic ultrasonography continue to improve, the lack of therapeutic potential and experienced centers limit their widespread application. Continued refinements in techniques and application of therapeutic ERCP enhance both the technical and clinical success rates for the procedure. © Lippincott-Raven Publishers.