Endoscopic Techniques in Management of the Liver and Biliary Tree: Upper Gastrointestinal Endoscopy

Endoscopic retrograde cholangiopancreatography (ERCP) is both an endoscopic and radiologic procedure. Although ERCP was once used as a diagnostic procedure, it is now performed almost exclusively for therapeutic purposes. The main therapeutic applications in the biliary tree are palliation of malignant biliary obstruction by biliary stent placement and removal of bile duct stones. There are however, many other biliary applications. Biliary manometry, performed at the time of diagnostic ERCP allows the diagnosis of specific types of sphincter of Oddi dysfunction and directs treatment toward endoscopic biliary sphincterotomy.