Current status and research progress of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of biliary and pancreatic system diseases


  • Li Yuehu Department of Hepatobiliary surgery, The second affiliated Hospital of Chongqing Medical University, Chongqing, China
  • Gong Jianp Department of Hepatobiliary surgery, The second affiliated Hospital of Chongqing Medical University, Chongqing, China
  • Shu Dong Department of General Surgery, Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China



Endoscopic retrograde cholangiopancreatography, Biliary tract diseases, Pancreatic diseases, Diagnosis, Therapy


Endoscopic retrograde cholangiopancreatography (ERCP) has been used clinically since the 1960s, after nearly half a century of development, it has become an important method for clinical diagnosis and treatment of biliary and pancreatic system diseases. In recent years, with the continuous updating of endoscopy equipment, the advancement of endoscopists’ technology, and the progress in understanding of biliary and pancreatic diseases, the application of ERCP in the diagnosis and treatment of biliary and pancreatic diseases has become more extensive, and the diagnosis and treatment procedures have become more standardized. At the same time, the diagnostic role of ERCP has declined slightly with the advancement of noninvasive imaging technology. But, its intervention role in treatment is more prominent, reducing dependence on traditional trauma therapy. The aim of the study was to summarize the application status of ERCP technology in biliary and pancreatic system diseases and the research progress in recent years.


Kurihara T, Yasuda I, Isayama H, Tsuyuguchi T, Yamaguchi T, Kawabe K, et al. Diagnostic and therapeutic single-operator cholangiopancreatoscopy in biliopancreatic diseases: Prospective multicenter study in Japan. World J Gastroenterol. 2016;22(5):1891-901.

Manes G, Paspatis G, Aabakken L, Anderloni A, Arvanitakis M, Soune P, et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2019,51(5):472-91.

Yaghoobi MMME, Meeralam YM, Shammari KM. Diagnostic accuracy of EUS compared with MRCP in detecting choledocholithiasis: a meta-analysis of diagnostic test accuracy of head-to-head studies. Gastroint Endosc. 2017,86(6):986-93.

Williams E, Beckingham I, Sayed G, Gurusamy K, Sturgess R, Webster G, et al. Updated guideline on the management of common bile duct stones. Gut. 2017,66(5):765-82.

Kamisawa T, Kaneko K, Itoi T, Ando H. Pancreaticobiliary maljunction and congenital biliary dilatation. Lancet Gastroenterol Hepatol. 2017;2(8):610-8.

Ono A, Arizono S, Isoda H, Togashi K. Imaging of Pancreaticobiliary Maljunction. Radiographics. 2020;40(2):378-92.

Ishibashi H, Shimada M, Kamisawa T, Fujii H, Hamada Y, Kubota M, et al. Japanese clinical practice guidelines for congenital biliary dilatation. J Hepatobiliary Pancreat Sci. 2017;24(1):1-16.

Wang Q, Moon SB, Zang J, Liu J, Weng H, Wang X, et al. Usefulness of pre-operative endoscopic retrograde cholangiopancreatography in diagnosis and management of forme fruste choledochal cyst in children. ANZ J Surg. 2020;90(6):1041-5.

Moura DTH, Moura EGH, Bernardo WM, Moura ETH, Baraca FI, Kondo A, et al. Endoscopic retrograde cholangiopancreatography versus endoscopic ultrasound for tissue diagnosis of malignant biliary stricture: Systematic review and meta-analysis. Endosc Ultrasound. 2018;7(1):10-9.

Moura DTH, Ryou M, Moura EGH, Ribeiro IB, Bernardo WM, Thompson CC. Endoscopic Ultrasound-Guided Fine Needle Aspiration and Endoscopic Retrograde Cholangiopancreatography-Based Tissue Sampling in Suspected Malignant Biliary Strictures: A Meta-Analysis of Same-Session Procedures. Clin Endosc. 2020;53(4):417-28.

Pereira P, Peixoto A, Andrade P, Macedo G. Peroral cholangiopancreatoscopy with the SpyGlass® system: what do we know 10 years later. J Gastrointestin Liver Dis. 2017;26(2):165-70.

Inoue T, Kitano R, Kobayashi Y, Ishii N, Sakamoto K, Ohashi T, et al. Assessing the diagnostic yield of controllable biopsy-forceps for biliary strictures. Scand J Gastroenterol. 2018;53(5):598-603.

Inoue T, Kitano R, Kobayashi Y, Ishii N, Sakamoto K, Ohashi T, et al. Assessing the diagnostic yield of controllable biopsy-forceps for biliary strictures. Scand J Gastroenterol. 2018;53(5):598-603.

Sun B, Hu B. The role of intraductal ultrasonography in pancreatobiliary diseases. Endosc Ultrasound. 2016;5(5):291-9.

Dacha S, Chawla S, Lee JE, Keilin SA, Cai Q, Willingham FF. Endoscopic retrograde cholangiopancreatography with ampullary biopsy vs ERCP alone: a matched-pairs controlled evaluation of outcomes and complications. Gastroenterol Rep. 2017;5(4):277-81.

Suarez AL, Pauls Q, Mauldin V, Cotton PB. Sphincter of Oddi Manometry: Reproducibility of Measurements and Effect of Sphincterotomy in the EPISOD Study. J Neurogastroenterol Motil. 2016;22(3):477-82.

Hyun JJ, Kozarek RA. Sphincter of Oddi dysfunction: sphincter of Oddi dysfunction or discordance? What is the state of the art in 2018?. Curr Opin Gastroenterol. 2018;34(5):282-7.

Saito H, Kadono Y, Shono T, Kamikawa K, Urata A, Nasu J, et al. Remaining issues of recommended management in current guidelines for asymptomatic common bile duct stones. World J Gastroenterol. 2021;27(18):2131-40.

Zhu J, Li G, Du P, Zhou X, Xiao W, Li Y. Laparoscopic common bile duct exploration versus intraoperative endoscopic retrograde cholangiopancreatography in patients with gallbladder and common bile duct stones: a meta-analysis. Surg Endosc. 2021;35(3):997-1005.

Vettoretto N, Arezzo A, Famiglietti F, Cirocchi R, Moja L, Morino M. Laparoscopic-endoscopic rendezvous versus preoperative endoscopic sphincterotomy in people undergoing laparoscopic cholecystectomy for stones in the gallbladder and bile duct. Cochrane Database Syst Rev. 2018;4(4):10507.

Karsenti D, Coron E, Vanbiervliet G, Privat J, Kull E, Bichard P, et al. Complete endoscopic sphincterotomy with vs. without large-balloon dilation for the removal of large bile duct stones: randomized multicenter study. Endoscopy. 2017;49(10):968-76.

Li G, Pang Q, Zhai H, Zhang X, Dong Y, Li J, et al. SpyGlass-guided laser lithotripsy versus laparoscopic common bile duct exploration for large common bile duct stones: a non-inferiority trial. Surg Endosc. 2021;35(7):3723-31.

Lee HS, Chung MJ, Park JY, Bang S, Park SW, Song SY, et al. Urgent endoscopic retrograde cholangiopancreatography is not superior to early ERCP in acute biliary pancreatitis with biliary obstruction without cholangitis. PLoS One. 2018;13(2):190835.

Sharzehi K. Management of Pancreatic Duct Stones. Curr Gastroenterol Rep. 2019;21(11):63.

Saghir SM, Mashiana HS, Mohan BP, Dhindsa BS, Dhaliwal A, Chandan S, et al. Efficacy of pancreatoscopy for pancreatic duct stones: A systematic review and meta-analysis. World J Gastroenterol. 2020;26(34):5207-19.

Çolak S, Gurbulak B, Gok AFK, Çakar E, Bektaş H. Endoscopic treatment of postoperative biliary fistulas. Ulus Travma Acil Cerrahi Derg. 2020;26(1):103-8.

Maxia S, Prado L, Bozhychko M, Sanjuan C, Casellas JA, Aparicio JR. Endoscopic coil embolization of major intrahepatic biliary leak. Endoscopy. 2020;52(9):322-3.

Perisetti A, Raghavapuram S, Tharian B. Refractory cystic duct stump leak treated with fibrin glue. Endoscopy. 2019;51(7):170-1.

Hu B, Sun B, Cai Q, Wong LJY, Ma S, Itoi T, et al. Asia-Pacific consensus guidelines for endoscopic management of benign biliary strictures. Gastrointest Endosc. 2017;86(1):44-58.

Tomoda T, Kato H, Miyamoto K, Saragai Y, Mizukawa S, Yabe S, et al. Comparison Between Endoscopic Biliary Stenting Combined with Balloon Dilation and Balloon Dilation Alone for the Treatment of Benign Hepaticojejunostomy Anastomotic Stricture. J Gastrointest Surg. 2020;24(6):1352-8.

Sohn SH, Park JH, Kim KH, Kim TN. Complications and management of forgotten long-term biliary stents. World J Gastroenterol. 2017;23(4):622-8.

Dorrell R, Pawa S, Pawa R. Endoscopic Management of Malignant Biliary Stricture. Diagnostics. 2020;10(6):390.

Xiao JB, Weng JY, Hu YY, Deng GL, Wan XJ. Feasibility and efficacy evaluation of metallic biliary stents eluting gemcitabine and cisplatin for extrahepatic cholangiocarcinoma. World J Gastroenterol. 2020;26(31):4589-606.

Larghi A, Rimbaș M, Tringali A, Boskoski I, Rizzatti G, Costamagna G. Endoscopic radiofrequency biliary ablation treatment: A comprehensive review. Dig Endosc. 2019;31(3):245-55.

Moole H, Tathireddy H, Dharmapuri S, Moole V, Boddireddy R, Yedama P, et al. Success of photodynamic therapy in palliating patients with nonresectable cholangiocarcinoma: A systematic review and meta-analysis. World J Gastroenterol. 2017;23(7):1278-88.

Keil R, Drabek J, Lochmannova J, Stovicek J, Koptova P, Wasserbauer M, Frybova B, et al. ERCP in infants, children, and adolescents-Different roles of the methods in different age groups. PLoS One. 2019;14(1):210805.

Yıldırım AE, Ozturk ZA, Konduk BT, Balkan A, Edizer B, Gulsen MT, et al. The safety and efficacy of ERCP in octogenarians: a comparison of two geriatric age cohorts. Acta Gastroenterol Belg. 2017;80(2):263-70.

Azab M, Bharadwaj S, Jayaraj M, Hong AS, Solaimani P, Mubder M, et al. Safety of endoscopic retrograde cholangiopancreatography (ERCP) in pregnancy: A systematic review and meta-analysis. Saudi J Gastroenterol. 2019;25(6):341-54.

Yamauchi H, Kida M, Imaizumi H, Okuwaki K, Miyazawa S, Iwai T, et al. Innovations and techniques for balloon-enteroscope-assisted endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy. World J Gastroenterol. 2015;21(21):6460-9.






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