Effect of Same-session EUS on ERCP in Pancreaticobiliary Diseases

Inclusion Criteria: 1. Patients aged ≥18 years; 2. Patients with pancreaticobiliary diseases definitively indicated for ERCP (as confirmed by HBP Specialists ); 3. No prior history of ERCP; 4. No pancreaticobiliary EUS examinations within the preceding 3 months. Exclusion Criteria: 1. Patients with clinically confirmed malignant lesions deemed surgically unresectable by multidisciplinary evaluation and requiring pathological diagnosis exclusively for chemotherapy/radiotherapy guidance; 2. Patients with confirmed diagnosis requiring only palliative biliary/pancreatic stent placement for obstructive jaundice ; 3. Patients with anatomical alterations or surgical history affecting EUS feasibility; 4. Severe systemic illness including severe hepatic, renal, cardiopulmonary and cerebrovascular diseases with high risk for endoscopic procedures; 5. Contraindication to iodinated contrast media (allergy or renal impairment preventing ERCP); 6. Pregnancy or lactation; 7. Patients with severe coagulopathy; 8. Declined informed consent; 9. Severe psychiatric disorder/non-cooperation precluding safe procedure.