Endoscopic Ultrasound Examination of the Papilla and the Biliary System

Examination of the papilla of Vater and biliary system is feasible using radial or longitudinal scanning echoendoscopes, respectively. The complete extrahepatic bile duct may be followed from the papilla to liver hilum. Additionally, the gallbladder and intrahepatic biliary tree of the left liver can be visualized. Altered anatomy and juxtapapillary duodenal diverticulum may impede the evaluation of the papilla and distal common bile duct. Benign stenosis or adenomyomatous hyperplasia of the papilla are conditions occurring predominantly in older patients with a history of gallbladder stones. EUS is the procedure of choice in the evaluation of a dilated common bile duct or in suspected biliary pathology when transabdominal ultrasound fails. This article is part of an expert video encyclopedia.