Endoscopic Retrograde Cholangiopancreatography (ERCP): Clinical Focus

Oral and Gastrointestinal

March 2001

Clinical Focus*

Patients with unknown or suspected common bile duct stones

What is the diagnostic performance of endoscopic retrograde cholangiopancreatography (ERCP) in detecting common bile duct stones in comparison to alternatives?
What are the outcomes of treatment using ERCP strategies compared to using surgical or medical management?
What is the diagnostic value of specific risk factors or predictive models for assessing the likelihood of having a common bile duct stone?

Patients with known or suspected pancreaticobiliary malignancy

What is the comparative diagnostic performance of ERCP tissue sampling techniques in establishing a tissue biopsy diagnosis of pancreaticobiliary malignancy, and how do these techniques compare to alternative nonsurgical tissue sampling techniques (e.g., endoscopic ultrasound-guided fine-needle aspiration [FNA] or percutaneous FNA)?
What is the diagnostic performance of ERCP in diagnosing the presence of malignance pancreaticobiliary obstruction in comparison to other imaging alternatives (e.g., endoscopic ultrasound [EUS] or magnetic resonance cholangiopancreatography [MRCP])?
What are the outcomes of treatment using ERCP for strategies to treat malignant pancreaticobiliary obstruction compared to using surgical or interventional radiology treatment?

Patients with pancreatitis

What is the diagnostic performance of ERCP in detecting underlying causes or complications of pancreatitis that are amenable to treatment in comparison to alternatives (e.g., EUS or MRCP)?
What are the outcomes of treatment using ERCP strategies compared to using surgical or medical therapy?

Patients with abdominal pain of possible pancreaticobiliary origin

What is the diagnostic performance of ERCP with sphincter of Oddi manometry in identifying a pancreaticobiliary origin of pain in comparison to alternatives (e.g., biliary scintigraphy, EUS, or MRCP)?
What are the outcomes of treatment using ERCP strategies compared to using surgical or medical therapy?
What patient, procedure, or operator factors are determinants of complications of ERCP?

*Addressed in the summary or evidence report.

Endoscopic Retrograde Cholangiopancreatography
Summary (Publication No. 02-E008, January 2002)
Evidence Report (Publication No. 02-E017, June 2002)
(PDF Files; File Download)

EPC: Blue Cross and Blue Shield Association TEC
Topic Nominator: NIH Office of Medical Applications of Research