Intraductal Ultrasound (IDUS)
Though many endoscopists perform EUS on patients regularly, IDUS is used by endoscopic gastroenterologists at the Pancreas Center to better visualize tumors and cysts within the pancreas gland itself. IDUS uses mini probes less than 2 mm in size which can be passed through standard endoscopes directly into pancreatic ducts for more accurate, higher resolution images.
Choledochoscopy and Pancreatoscopy
Pancreas Center endoscopists frequently employ the latest technology for evaluation of the bile and pancreatic ducts with direct visualization using the SpyGlassTM Direct Visualization System for singleoperator duodenoscope assisted cholangiopancreatoscopy (SODAC). This procedure allows visually directed diagnostic and therapeutic interventions. It is especially useful in difficult-to-access ducts of patients with indeterminant biliary and pancreatic strictures, premalignant lesions such as IPMN, and difficult to manage stones.
Altered Anatomy ERCP: Double Balloon and Minimal Access Surgery Techniques
For patients with difficult post-surgical anatomy (long afferent limbs after Whipple, Billroth II, Roux Y hepaticojejunostomy, and gastric bypass operations) who are not candidates for endoscopic rendezvous procedures, ERCP can now often be accomplished with standard ERCP accessories using a double-balloon endoscopy system. When this is not possible, Pancreas Center endoscopists and surgeons team together to use minimal access surgery techniques to provide ERCP access.