[Therapeutic endoscopy in pancreas].

The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of pancreatic disease is continuing to evolve. In view of increasingly noninvasive diagnostic imaging modalities for pancreatic disease, ERCP should be mainly restricted to therapeutic indications. This article reviews recent publications spanning a wide range of topics related to therapeutic pancreatic endoscopy: This review article will be focused on the technical and therapeutic aspects of the following topics: 1. Post-ERCP pancreatitis and preventive methods for this entity, 2. Recurrent severe pancreatitis, 3. Oddi sphincter dysfunction, 4. Pancreatic duct stenosis and lithiasis in chronic pancreatitis, 5. Hereditary pancreatitis, 6. Pseudocysts and pancreatic abscesses, and 7. Pancreatic duct fistulae. Pancreatic endotherapy is technically demanding and potentially hazardous; these interventions should be restricted to high-volume centers with options for an interdisciplinary team approach. Methods that have not yet been established should be evaluated in carefully designed prospective trials.