INTRODUCTIONEndoscopic retrograde cholangiopancreatography (ERCP) has been the premier diagnostic and therapeutic endoscopic procedure in the management of pancreatic and biliary diseases (PBD). The use of endoscopic ultrasound (EUS), including EUS-guided fine needle aspiration (FNA), of pancreatic and biliary tumours has become more widely available in the last decade and has gradually replaced diagnostic ERCP. Together with EUS, other imaging modalities like magnetic resonance cholangiopancreatography (MRCP) have resulted in a decrease in the number of ERCPs. With the advent of interventional EUS, ERCP is at risk of being completely eclipsed.

METHODSA search of all relevant articles on EUS and ERCP from Medline and peer-reviewed journals.

RESULTSThis review article examines the exact place of ERCP and EUS and their relative contributions in the management algorithm of PBD.

CONCLUSIONAlthough diagnostic EUS, including EUS-guided FNA, is well established in the evaluation of PBD, interventional EUS is still in its infancy and its true potential is unknown. Therefore, therapeutic ERCP still has a vital, albeit smaller role to play in the treatment of pancreatic and biliary diseases.

Biliary Tract Diseases ; diagnosis ; Cholangiopancreatography, Endoscopic Retrograde ; trends ; utilization ; Clinical Competence ; Cost-Benefit Analysis ; Endosonography ; economics ; utilization ; Humans ; Pancreatic Diseases ; diagnosis

Argon ; Gastric Antral Vascular Ectasia ; physiopathology ; therapy ; Humans ; Laser Coagulation ; methods ; Male ; Middle Aged