ERCP and Related Technologies: A Clinical Update

David L. Carr-Locke, MD, FRCP, FACG, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Disclosures

May 22, 2000

In This Article

Live Demonstrations

During the 2 days of the symposium, the faculty, including Dr. Carr-Locke, Dr. Huibregtse, Dr. Lo, Dr. Chung, Dr. Deviere, Dr. Haber, and Dr. Lehman, demonstrated a wide variety of biliary and pancreatic techniques through a state-of-the-art audio visual teleconferencing system, connecting 2 ERCP rooms at Torrance Memorial Medical Center with the hospital conference center. The audience was able to hear and communicate with the endoscopists through a panel of local host moderators and was able to observe procedures on 4 large screens that simultaneously showed images of endoscopy, fluoroscopy, endosonography, the endoscopists, and nurses.

A number of techniques were demonstrated and discussed, including:

  • major and minor papilla cannulation

  • sphincterotomy in the presence of a duodenal diverticulum

  • balloon dilation of a benign bile duct stricture

  • evaluation of unexplained recurrent pancreatitis

  • biliary sphincterotomy and stent placement for stenosis due to chronic pancreatitis

  • endosonography prior to cystgastrostomy

  • electrohydraulic lithotripsy for bile duct stone

  • mechanical lithotripsy for bile duct stone

  • diagnostic cholangioscopy of an intraductal mass

  • therapy of a dominant stricture in sclerosing cholangitis

  • minor papilla sphincterotomy for pancreas divisum

  • ERCP in Roux-en-Y anatomy

  • difficult pancreatic sphincterotomy and drainage of fluid collection

  • very difficult and creative use of cholangioscopy for the treatment of a giant bile duct stone following a previous pancreaticoduodenectomy

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