Technology status evaluation: Endoscopic pancreatic therapy

Overall favorable outcomes and the safety profile for pancreatic endotherapy has led to continued cautious enthusiasm in the field. Standard therapeutic ERCP techniques are appropriate in the settings of severe acute biliary pancreatitis, symptomatic biliary obstruction associated with chronic pancreatitis, and in patients with a high likelihood of choledocholithiasis who have recovered from acute pancreatitis. Endoscopic evaluation and treatment of idiopathic acute pancreatitis, pseudocysts, and pancreatic stones and strictures often requires additional expertise and equipment. Pancreatic endotherapy has potentially hazardous complications and should only be performed by trained individuals. Patients with complex pancreatic disorders may require a multidisciplinary approach incorporating surgical, radiological, and endoscopic techniques. Further technical developments and outcomes data are awaited.