Escalating complexity of endoscopic retrograde cholangiopancreatography over the last decade with increasing reliance on advanced cannulation techniques.

There was a trend toward an increased proportion of ERCPs performed for biliary stricture evaluation and management, from 19% in 2008 to 24% in 2013 and 29% in 2018 ( P = 0.07, Figure 3 ), however this did not reach statistical significance when correction for repeated measures was performed.

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