The patient on the table is bleeding, the guidewire keeps slipping into the pancreatic duct, and the next decision determines whether they leave with cleared stones or post-ERCP pancreatitis. Apply yesterday's reflexes to today's complexity and you get the perforation closed three hours late, the stricture left undilated, the dysplasia missed at withdrawal, the leak that becomes a sepsis admission. This handbook delivers point-of-care procedural reasoning across luminal, pancreaticobiliary, and interventional endoscopy — what to do, when to do it, and what to do when it does not work. Inside this book: • Wire-guided cannulation under pressure — execute the double-wire technique, deploy a prophylactic pancreatic stent, and avoid the precut you do not actually need • Forrest classification with intent — stratify ulcer bleeding by stigmata, deploy combination therapy, and time the second-look that prevents the rebleed • Optical diagnosis at the polyp — apply NICE and JNET in real time to choose cold-snare, hot-snare, EMR, or referral for ESD before the snare even opens • Step-up therapy for walled-off necrosis — deploy a lumen-apposing metal stent, sequence necrosectomy sessions, and avoid the open surgery • POEM technique end-to-end — execute mucosotomy, submucosal tunnel, selective myotomy, and closure across all three Chicago Classification subtypes of achalasia • Cholangioscopy for indeterminate strictures — direct visualization, targeted SpyBite biopsy, and the management decision the brushings could not deliver • Perforation closure under pressure — choose between TTSC, OTSC, suturing, or stent across the GI tract before peritonitis develops • EUS-guided biliary drainage — perform choledochoduodenostomy or hepaticogastrostomy when ERCP has failed and percutaneous drainage is the wrong answer For gastroenterologists, advanced endoscopists, hepatobiliary surgeons, fellows in advanced endoscopy training, and the GI nurses and technologists who staff the procedure room. Open the book, sharpen the procedural reasoning, and bring it to the next case. ⭐⭐⭐⭐⭐ The Definitive Clinical Reference for the Modern Endoscopist This is precisely the endoscopy handbook that gastroenterology trainees and practicing clinicians have needed. The seven-part structure moves logically from equipment fundamentals and sedation pharmacology through luminal endoscopy, pancreaticobiliary procedures, and advanced therapeutic techniques, culminating in a dedicated chapter on complication recognition and management. The Evidence Box and Summary and Key Concepts features at the close of every chapter make this equally valuable as a board-prep resource and a quick bedside reference. -Dr. James Whitfield, MD, FACG, Program Director, Gastroenterology Fellowship ⭐⭐⭐⭐⭐ Exceptional Depth on ERCP and Interventional EUS The pancreaticobiliary section alone is worth the price of admission. The coverage of difficult cannulation strategies — precut sphincterotomy, the double-wire technique, and pancreatic stent-assisted access — is detailed and clinically precise, and the chapter on interventional EUS addresses celiac plexus neurolysis, EUS-guided biliary drainage, and endoscopic gastroenterostomy with a level of procedural nuance rarely found outside peer-reviewed literature. Any fellow rotating through an advanced endoscopy service should have this on the desk. -Dr. Patricia Kowalski, MD, Advanced Endoscopy Fellow Supervisor, Academic Medical Center ⭐⭐⭐⭐⭐ Finally, a Handbook That Takes Complication Management Seriously Most endoscopy texts relegate complications to an afterthought. This one devotes an entire closing chapter to the subject — perforation recognition and endoscopic closure, post-ERCP pancreatitis prophylaxis, post-sphincterotomy bleeding, and cardiopulmonary sedation events — with structured decision pathways that reflect how clinical judgment actually functions under pressure. The consistent integration of ASGE, ACG, and ESGE guideline recommendations throughout is a genuine strength. -Rachel Simmons, MSN, APRN, GI Specialty Practice, Tertiary Referral Center ⭐⭐⭐⭐ Colonoscopy Quality Metrics Covered with Uncommon Rigor The chapters on colonoscopy technique and colorectal polyp management stand out for their attention to quality benchmarking — adenoma detection rate, withdrawal time targets, cecal intubation standards, and post-polypectomy surveillance intervals are all addressed with current guideline alignment. The integration of the Paris, NICE, and JNET optical diagnosis classifications into the polyp resection discussion is exactly how these tools should be taught. -Dr. Samuel Torres, MD, Gastroenterologist, Community Health System ⭐⭐⭐⭐⭐ Third-Space Endoscopy and ESD Explained with Procedural Clarity The advanced therapeutic section covering ESD, POEM, Z-POEM for Zenker's diverticulum, and submucosal tunneling endoscopic resection is among the most clearly written treatments of