International Session（Symposium）10(JGES・JSGE・JSGS・JSGCS)
Sat. November 7th   14:30 - 17:00   Room 11: Portopia Hotel South Wing Topaz
IS-S10-1_E
 Current status of advanced pancreaticobiliary endoscopy in the United States.
Makoto Nishimura
Memorial Sloan Kettering Cancer Center
There has been a huge demand for diagnostic and therapeutic endoscopy for pancreaticobiliary disorders worldwide. Endoscopic approaches, including ERCP and endoscopic ultrasound (EUS), are similar around the world. However, there are some differences between Japan and the United States (US).
For example, in ERCP cannulation, catheter with contrast injection is generally used in Japan, whereas a sphincterotome using the wire-guided method is common in the US. In the US, balloon dilation (EPBD) is rarely used, and endoscopic sphincterotomy (EST) is standard approach for the major papilla. Once the wire is inserted into the pancreatic duct (PD), rectal administration of indomethacin and the placement of a plastic pancreatic stent is standard to prevent post-ERCP pancreatitis.
EUS-FNA is a standard procedure in the US for pathological confirmation of pancreaticobiliary malignancy, and ERCP is rarely used to diagnose pancreatic cancer. EUS-FNA is also commonly used to collect pancreatic cyst fluid, and discussion regarding peritoneal seeding is underway in the US. Interventional EUS with an AXIOS stent is one of the standard procedures used in the US, and gastrojejunostomy by AXIOS for the patient with post Whipple procedure is one of majority in our institution.
In this presentation, I would like to discuss the differences between Japan and the US in evaluating and treating pancreaticobiliary disorders.
Index Term 1: EUS
Index Term 2: ERCP
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