Managing Risks Related to ERCP in Elderly Patients with Difficult Bile Duct Stones

Excerpt

Endoscopic retrograde cholangiopancreatography (ERCP), since its initial description over four decades ago, has revolutionized the management of biliary disease, with the ability to not only to diagnose biliary stones and strictures, but also to nonsurgically extract stones and dilate and stent obstructions and strictures. Although the development of safer and relatively noninvasive imaging techniques such as magnetic resonance cholangiopancreatography and endoscopic ultrasound has greatly reduced the number of solely diagnostic ERCPs performed, ERCP is still needed for its therapeutic capabilities, in particular ERCP with sphincterotomy (ES), which is generally regarded as safe and effective therapy, with short-term adverse events occurring in 5–10 % of subjects [1, 2]. …