Unlocking the Potential of ERCP: A Comprehensive Overview

[Snehal Shaha]

Introduction
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a minimally invasive procedure used to diagnose and treat diseases of the bile and pancreatic ducts. It is used to diagnose conditions such as bile duct stones, biliary strictures, and pancreatic cancer. The procedure involves the insertion of an endoscope into the patient’s mouth and then into the duodenum. A small catheter is then passed through the endoscope and into the common bile duct or pancreatic duct. Dye is injected through the catheter and x-rays are taken to help diagnose the condition.

Global ERCP Market Overview
The global ERCP market in terms of revenue was estimated to be worth $1.3 billion in 2021 and is poised to reach $2.0 billion by 2026, growing at a CAGR of 9.6% from 2021 to 2026.

Endoscopic retrograde cholangiopancreatography (ERCP) is a medical process that involves the insertion of a thin, flexible tube that is fitted with a camera through the mouth and esophagus, and into the duodenum. The procedure is used to diagnose and treat diseases related to the gallbladder, bile ducts, and pancreas. This medical procedure is used to diagnose and treat a variety of conditions, including pancreatic cancer, bile duct cancer, pancreatitis, and gallstones.

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Drivers of the ERCP Market
Nowadays, the global incidence of cancer is increasing. According to the WHO, cancer is the second-leading cause of death globally and was responsible for 9.6 million deaths in 2018. According to the American Cancer Society's estimates, about 41,260 new cases of liver cancer and intrahepatic bile duct cancer will be diagnosed in the US in 2022. Liver cancer incidence rates have more than tripled since 1980, while death rates have more than doubled during this time. In 2021, around 60,430 new pancreatic cancer cases will be diagnosed in the US. Every year in the United Kingdom (2016–2018), approximately 10,500 new pancreatic cancer cases and 6,200 new liver cancer cases were diagnosed. Globally, 458,918 new cases of pancreatic cancer were reported in 2018, and 355,317 new cases are estimated to occur until 2040 (GLOBOCAN 2018 estimates). Since ERCP is often used as a diagnostic tool in hepatic, biliary, and pancreatic cancers, the rising incidence of these cancers is directly related to the impact on the ERCP market.

Opportunities of ERCP Market
Brazil, Russia, India, China, and South Africa (BRICS) are among the fastest-growing economies globally. According to the World Economic Forum, the emerging economies will account for around one-third of global healthcare expenditure in 2021. More than half of the world's population resides in India and China, owing to which these countries are home to the highest number of patients.

The increasing burden of cancer, rapid improvements in healthcare infrastructure, the rapid growth of medical tourism, and the presence of flexible regulation in these countries encourage players in the endoscopy equipment market to expand their presence in emerging countries.
Several endoscopy equipment manufacturers are currently setting up their facilities in Asia, the Middle East, and Latin America. Karlstrom, for example, has already established manufacturing and R&D facilities in these countries. In addition, market saturation in developed regions, such as North America and Europe, will force manufacturers to focus on emerging markets in the coming years.

Regional ERCP Market Analysis
Governments in several Latin American countries focus on improving their respective healthcare systems, and the healthcare sector in Brazil has undergone significant changes, making the country one of the world's most promising and attractive markets. Along with this, Japan's well-developed healthcare system with universal health insurance coverage and the focus of countries such as China and India on healthcare infrastructure improvements to serve large populations of patients with critical illnesses, including cancer and tumors, are driving the market in these regions forward at a rapid pace.

Major Players in the ERCP Market
The major players in the global ERCP market include Olympus Corporation (Japan), CONMED Corporation (US), Fujifilm Holdings Corporation (Japan), HOYA Corporation (Japan), KARL STORZ SE & Co. KG (Germany), Ambu A/S (Denmark), Boston Scientific Corporation (US), Johnson & Johnson (US), Medtronic, PLC (Ireland), Cook Medical (US), and B. Braun Melsungen AG (Germany).

Recent Developments in ERCP Market
• In January 2022, Cook Medical (US) launched an endoscopic clipping device, namely Instinct Plus, which is compatible through a duodenoscope, has applications for defect closure, anchoring procedures and prophylactic clipping in the gastrointestinal (GI) tract.
• In May 2021, STERIS PLC (US) acquired Cantel Medical (US) which enabled STERIS Healthcare to expand its product portfolio and cater to customers worldwide.
• In March 2021, Fujifilm Holdings Corporation (Japan) acquired Hitachi, Ltd.’s Diagnostic Imaging-related Business (Japan), adding to the former’s stronghold in the healthcare business.
• In October 2020, Olympus Corporation (Japan) launched two endotherapy devices, StoneMasterV and VorticCatchV, to increase the efficiency in bile duct stone management and retrieval for ERCP announced a partnership with Holberg to develop and distribute the Autoscore algorithm.

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Conclusion:
Endoscopic Retrograde Cholangiopancreatography (ERCP) is an important diagnostic and therapeutic tool for the diagnosis and management of pancreatic and biliary diseases. This growth is attributed to the rising prevalence of gastrointestinal diseases, growing geriatric population, and rising demand for minimally invasive procedures.
In addition, the increasing prevalence of gallstones, rising awareness regarding ERCP procedures, and technological advancements in the ERCP systems are further expected to boost the growth of the market. However, the high cost of the procedure and the lack of skilled professionals are expected to impede the growth of the market.
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