Diagnostic The following represent indications for<unk> , particularly if or when less invasive options are not adequate or definitive: Fluoroscopic image of common bile duct stone seen at the time of<unk> . The stone is impacted in the distal common bile duct. A nasobiliary tube has been inserted. Fluoroscopic image showing dilatation of the pancreatic duct during<unk>  investigation. Endoscope is visible. * Obstructive jaundice – This may be due to several causes * Gallstones with dilated bile ducts on ultrasonography * Indeterminate biliary strictures and suspected bile duct tumors * Suspected injury to bile ducts either as a result of trauma or of iatrogenic origin * Sphincter of Oddi dysfunction * Chronic pancreatitis is currently a controversial indication due to widespread availability of safer diagnostic modalities including endoscopic ultrasound, CT, and MRI/MRCP * Pancreatic tumors no longer represent a valid diagnostic indication for<unk>  unless they cause bile duct obstruction and jaundice. Endoscopic ultrasound represents a safer and more accurate diagnostic alternative Therapeutic<unk>  may be indicated in the above diagnostic scenarios when any of the following are needed: * Endoscopic sphincterotomy of the sphincter of Oddi * Extraction of gallstones or other biliary debris * Insertion of a stent through the major duodenal papilla and ampulla of Vater into the common bile duct and/or the pancreatic duct * Dilation of strictures (e.g. primary sclerosing cholangitis, anastomotic strictures after liver transplantation)
Endoscopic retrograde cholangiopancreatography
Biliary endoscopic sphincterotomy
Cholecystectomy
Cholecystostomy
Cholecystenterostomy
Percutaneous transhepatic cholangiography
Splenic aspiration
Perihepatic packing