The importance of diagnostic endoscopic retrograde cholangiography (ERCP) has dramatically
decreased owing to the development of less invasive techniques such as ultrasonography,
computed tomography, endoscopic ultrasonography, and finally magnetic resonance cholangiopancreatography
(MRCP). MRCP is becoming the gold standard in the diagnostic work-up of the pancreaticobiliary
duct. However, MRCP cannot solve all the problems that occur, and still has inadequate
resolution for small stones and tiny pancreatic and bile duct lesions. ERCP continues
to be useful in difficult cases and when the diagnosis is uncertain, particularly
when fluid collection and tissue sampling are necessary. However, several alternatives
to sphincter of Oddi manometry have been proposed. Finally, ERCP is always the first
step before endoscopic treatment, which in contrast to diagnostic ERCP is still widely
used.
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M.D. T. Ponchon
Hôpital Edouard Herriot Place d'Arsonval
69437 Lyon Cedex 03
France
Telefon: +33-4-72 11 01 47
eMail: thierry.ponchon@chu-lyon.fr
