Biliary Diseases and Therapeutic Endoscopy

Columbia’s therapeutic endoscopy specialists are national leaders in the minimally invasive treatment of biliary disease and other digestive disorders. We are currently the largest and most pre-eminent endoscopy center in the New York region, performing over 12,000 procedures yearly. Each day, our patients benefit from the care of our dedicated physicians, who draw on cutting-edge research and technologies developed by our experts, who are leading advances in the field.

Endoscopy is a powerful diagnostic tool that allows physicians to see different portions of the digestive tract. A small, flexible tube with a camera at the tip can be guided through the mouth or rectum into the area of the digestive tract the physician needs to explore. In recent years, endoscopy has also evolved into a therapeutic tool that lets physicians evaluate and treat a condition at the same time. The same endoscopy tube acts as a portal into the GI system, enabling physicians to remove obstructions, destroy cancerous tumors, and perform other important therapies, all without making an incision in the skin.

Using these minimally invasive techniques, our highly skilled therapeutic endoscopy team can often identify and resolve a patient's problem in a single visit.

Conditions We Treat

Our Therapeutic Endoscopy Center brings experience and leading-edge research to both common and rare conditions, including:

• Bile duct stones
• Bile duct leaks and narrowing
• Cancers of the pancreas, esophagus, stomach, small bowel, bile ducts, and liver
• Pancreatitis, infections, and abscesses of the pancreas
• Barrett’s esophagus and other precancerous lesions of the GI tract
• Obstructions, pseudocysts, tumors, and stones
• Obscure GI bleeding and large GI polyps
• Achalasia (abnormal tension in the esophagus)

Our Services

Our center performs a high volume of ERCP and EUS procedures, providing diagnostics and treatments that include:

• Endoscopic retrograde cholangiopancreatography (ERCP): Combines endoscopy with x-ray technology to diagnose and treat problems of the gallbladder, biliary system, pancreas, and liver
• Biliary and pancreatic stent placement: Endoscopic placement of a tube to drain the bile duct or pancreatic duct
• Stone removal: Endoscopic retrieval of stones from the bile duct or pancreatic duct
• Endoscopic ultrasound (EUS): A procedure that uses ultrasound to detect tumors in the pancreas, stage gastrointestinal cancers, and detect stones in biliary ducts

Advanced Technologies

Our therapeutic endoscopy team has been among the first in the nation to offer new technologies and advanced approaches, including:

• New imaging techniques (including The Spyglass Visualization system): Allows doctors to view the pancreas with a precision never achieved before, which leads to a more reliable diagnosis and minimally invasive treatment options
• The Confocal Laser Endomicroscope: Obtains enhanced images of the digestive tract to detect and treat early cancers
• Radiofrequency ablation: Uses electrical energy to destroy cancerous and precancerous tissue and is an effective treatment for Barrett’s esophagus
• Endoscopic mucosal dissection (EMD): Represents a significant advance in treating Barrett’s esophagus and early GI cancer, allowing doctors to remove tumors without a surgical incision
• Photodynamic therapy: Uses light waves to treat small shallow tumors in the esophagus of select patients
• Cryotherapy or tissue-freezing: Addresses a variety of lesions in the digestive tract
• DNA analysis of tissue samples (Fluorescent In Situ Hybridization, or FISH): Helps to evaluate abnormal narrowing of the bile duct to diagnose cancers