Ultrasound-Guided ERCP Without Fluoroscopy Is Less Effective Than Standard ERCP with Fluoroscopy

Some endoscopists desire to minimize or even eliminate the use of fluoroscopy when performing endoscopic retrograde cholangiopancreatography (ERCP). To evaluate the effectiveness of ERCP without fluoroscopy, with endoscopic ultrasound (EUS) used to confirm duct clearance, researchers randomized 114 patients to undergo standard ERCP with fluoroscopy or an EUS to evaluate the size and number of stones, followed by ERCP without fluoroscopy (with biliary access confirmed by aspirating bile) and then use of limited fluoroscopy just to confirm duct clearance. If patients failed EUS-guided ERCP, they were converted to standard ERCP.

Cannulation rates were not significantly different between the two groups, but EUS-guided ERCP was inferior to standa…