Managing choledocholithiasis in patients after Roux-en-Y gastrectomy is challenging, and with no excluded stomach, endoscopic ultrasound (EUS)-guided transmural lumen-apposing metal stent placement is significantly more

Choledocholithiasis can be identified through multiple means, including a right upper quadrant ultrasound, endoscopic ultrasound (EUS), endoscopic retrograde cholangiography (ERCP), magnetic resonance cholangiopancreatography (MRCP), and

Thermal injury from biliary sphincterotomy is thought to play a role in at least a proportion of post-ERCP pancreatitis (PEP) cases. Thus, the present study

Single-use duodenoscopes were developed to eliminate the risk of duodenoscope-associated transmission of infections. However, there are concerns that the performance of single-use duodenoscopes may not

In addition to dietary modification and pharmacologic therapy, behavioral therapy has become a recognized treatment for irritable bowel syndrome (IBS) and is now integrated into

Same-admission cholecystectomy is recommended for patients with mild gallstone pancreatitis (GSP) to reduce recurrent GSP events and lower costs. However, adherence to same-admission cholecystectomy remains

In select patients – most commonly during pregnancy – using a fluoroscopy-free approach to stone removal is preferred. Given some initial success with this approach

ERCP is a vital endoscopic procedure for the management of pancreatobiliary disease but is associated with serious adverse events, including mortality. Although a central tenet

ERCP is generally the first-line approach for palliation of distal malignant biliary obstruction (DMBO), but interest in the use of endoscopic ultrasound (EUS)-guided transmural drainage

It is clear that metal stents are superior to plastic stents for palliation of distal malignant biliary obstruction (dMBO). Among self-expanding metal stents (SEMS), there

Palliation of malignant biliary obstruction is required to facilitate oncologic therapy and relief of symptoms. Although this is almost always performed with ERCP, biliary cannulation

Adequate patient sedation is essential for the successful completion of ERCP; however, delivery methods of anesthesia vary between providers, with most endoscopists favoring deep sedation

Successful and safe ERCP requires the endoscopist to cannulate the duct of interest successfully and efficiently. Although operator skill clearly influences procedure success, there is

Pancreatitis after ERCP is one of the most common and morbid adverse events following any gastrointestinal endoscopy procedure. It is imperative that the consent process

Most inoperable malignant biliary strictures are best treated with self-expanding metal stents (SEMS); however, a significant portion of patients develop stent occlusion from neoplastic or

Pancreatic necrosis often results in main pancreatic duct injury and eventual discontinuity, or so-called disconnected pancreatic duct syndrome (DPDS), with recurrent symptoms from duct obstruction

Pancreatic ductal adenocarcinoma (PDAC) continues to have a dismal prognosis at the time of presentation. Survival is improved with diagnosis at an early stage, but

Transmission of multidrug-resistant organisms between patients undergoing ERCP prompted the U.S. Food and Drug Administration to issue guidance for endoscopy departments to adopt intensified reprocessing

Electrohydraulic lithotripsy (EHL) and laser lithotripsy are both well-established methods for the treatment of biliary and genitourinary stones. Several retrospective series have described successful pancreatoscopy-guided

Cholecystectomy before hospital dismissal is advised for most cases of acute biliary pancreatitis (ABP). Surgery is often delayed in the setting of pancreatic necrosis to

Many patients with walled-off pancreatic necrosis (WON) require debridement following minimally invasive drainage. This often entails serial procedures with cumulative expense and risk. These authors

Ampullary, periampullary, and duodenal adenomas commonly occur in familial adenomatous polyposis (FAP). Their detection and management are fraught with challenges related to balancing the risk

A variety of techniques have been described for achieving deep biliary cannulation, a necessary prelude to most endoscopic retrograde cholangiographic (ERCP) procedures. The rate of

Limited reports have suggested that endoscopic biliary sphincterotomy (ES) at the time of transpapillary biliary stent placement may reduce the risk of post-ERCP pancreatitis (PEP).

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer mortality since most cancers are advanced at diagnosis. Early identification of these cancers is

Establishing a firm diagnosis for indeterminate biliary strictures is often challenging. The current standard of practice is fluoroscopic and cholangioscopic characterization with brush and biopsy

Biliary obstruction with associated cholangitis usually is managed with the use of endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction or stent decompression of the bile

Compression of the distal bile duct within a fibrotic pancreas is one complication of chronic pancreatitis (CP), which can lead to chronic cholestasis, cholangitis, and

Severe acute cholecystitis (AC) often is palliated with percutaneous or endoscopic drainage 6 to 12 weeks prior to preplanned interval cholecystectomy. Many patients with severe

The optimal treatment for cholangiocarcinoma (CCA) or ampullary carcinoma (AC) is surgery. When deemed unresectable and not amenable to neoadjuvant therapy followed by liver transplantation,

The potential for interpatient transmission of infections by contaminated duodenoscopes is a significant concern in the practice of ERCP. Pending further understanding and development of

Multiple guidelines recommend performing cholecystectomy (CCy) before hospital dismissal for patients with mild gallstone pancreatitis that is not complicated by infection or necrosis. In this

Management of walled-off pancreatic necrosis often benefits from direct transmural endoscopic necrosectomy. This retrospective chart review assessed the utility of hydrogen peroxide (H2O2) lavage as

Bilateral placement of metal stents for malignant hilar strictures (MHS) can be challenging. Two approaches have been used, each with potential benefits and challenges.  In

A variety of recommendations have been proposed for predicting choledocholithiasis based upon presenting signs, symptoms, initial laboratory studies, and imaging. In this retrospective study, the

Deep access to the bile duct or the pancreatic duct is required in order to complete all subsequent therapeutic ERCP maneuvers. Precut sphincterotomy (PCS) refers

Gallbladder removal or drainage is a key component of treatment for acute cholecystitis. When the risk of urgent cholecystectomy is considered prohibitive, the optimal alternative

The development of single-use (disposable) endoscopes is one approach to eliminating infection transmission between sequential patients during endoscopy. This single-center study randomized patients undergoing endoscopic

Endoscopic biliary sphincterotomy (ES) is the standard prelude to duct stone removal; however, it carries moderate risk for both pancreatitis and bleeding and can be

Extracorporeal shock wave lithotripsy (ESWL) has become the dominant therapy for the treatment of symptomatic pancreatic duct stone obstruction in chronic calcific pancreatitis. In the

Lapses in reprocessing of flexible endoscopes have been demonstrated in many environments and are thought to contribute to the transmission of infection between patients.  The

Endoscopic decompression and drainage of immature pancreatic and peripancreatic fluid collections with incomplete encapsulation by a wall of surrounding tissue have generally been avoided out

Endosonographic drainage of pancreatic cysts is currently regarded as the standard throughout the world, in comparison with other treatments (such as percutaneous drainage or surgery).

The latest developments in the field of gastroenterology and endoscopy are presented every year at Digestive Diseases Week (DDW) in Chicago — although in recent

The application of non-steroidal anti-inflammatory drugs (NSAIDs) such as indometacin or diclofenac to prevent post-ERCP pancreatitis (PEP) has been examined in several randomized trials throughout

Pancreatitis can cause various severe complications such as acute fluid collections with superinfected necrotic content requiring drainage and removal of necrotic debris. Here we demonstrate

Cystic pancreatic tumors are increasingly being detected at the asymptomatic stage, thanks to improved imaging, and “screening” imaging in particular. This often then leads to