The role of endoscopic retrograde cholangiopancreatography at an academic medical center in the era of less-invasive diagnostic tools

Abstract

Evaluation of: Coté GA, Singh S, Bucksot LG et al. Association between volume of endoscopic retrograde cholangiopancreatography at an academic medical center and use of pancreatobiliarytherapy. Clin. Gastroenterol. Hepatol. 10(8), 920–924 (2012).

Many patients have pancreatobiliary diseases involving complications and comorbidities. This study shows the trends in the use of endoscopic retrograde cholangiopancreatography (ERCP) at an academic medical center from 1994 to 2009. During that time, the use of ERCPs for the treatment of bile duct stones reached a plateau and those for the treatment of pancreas divisum showed a decline. However, endoscopic therapy for benign biliary stricture and management for obstructive chronic pancreatitis increased during this period. There was a trend toward greater use of therapeutic ERCP for bile duct stenting involving metal stents and for pancreatic therapeutics. In that same period, there was an increase in the proportion of patients who had undergone unsuccessful ERCP at various other centers. Consequently, at academic medical centers, ERCP has become an increasingly complex intervention. Increasing numbers of patients with comorbidities, complications and history of failed ERCPs are being referred to academic centers to receive endotherapy.

Keywords::

• academic medical center
• ERCP
• EUS
• MRCP
• pancreatobiliary diseases

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.