ENDOSCOPC RETROGRADE CHOLANGIOPANCREATOGRAPHY OR ERCP
ERCP
The Liver and Pancreas
The liver produces bile that helps in digestion. Bile passes through the liver ducts and is stored in the gall bladder. Bile is secreted from the bile duct into the first part of the small intestine, the duodenum. The pancreas is a six to eight inches long organ that lies behind the stomach and secretes digestive juices that enter small intestine through the same opening as the bile.
The Equipment
ERCP is performed by using a flexible, small diameter, fiber-optic tube (endoscope)which has a computer chip that transmits images to a video monitor. The endoscope has an open channel, through which instrumentation of the bile and pancreatic duct is possible to take biopsies and remove stones, among other things.
Uses and Advantages of the Procedure
ERCP helps in diagnosing and treating diseases of the bile and pancreatic ducts and gall bladder. Some of these are:
Gallstones trapped in the main bile duct can be seen and removed
Blockages of the bile and pancreatic ducts can be removed and tubes called stents placed to maintain patency of ducts
Jaundice due to blockage of bile ducts may be helped by removing the blockage
Cancer of the bile ducts or pancreas can be diagnosed and measures taken towards treatment
Pancreatitis (pancreatic inflammation) can improve after blockage removal
The Preparation
The patient should not eat or drink up to 8 hours prior to the procedure. Any other instructions given by the physician especially in regards to medication need to be carefully followed.
The Procedure
The procedure is performed in an x-ray room with the patients positioned on their left side or stomach. The throat is anesthetized with a spray or liquid. Intravenous sedation may be given to relax the patient. The patient breaths comfortably during the exam.The endoscope is gently introduced through the throat and passed through the stomach and upper intestine. A thin tube is inserted through the endoscope into the main duct entering the duodenum. Dye is inserted into the bile and/or pancreatic ducts and x-rays are taken. Stones can be removed if visualized. To aid in the removal of stones or blockages, a small incision may be made. Stents or small tubes may be inserted in obstructed ducts to help the flow of digestive juices. Biopsies of suspicious tissue may be taken.
After the Procedure
The patient may have effects of the sedative and needs to bring someone to drive them home. The gastroenterologist may discuss the results immediately after the procedure or on a follow up visit if further tissue testing results are awaited.
Side Effects and Risks
Mild throat irritation
Lingering sedation
3-5% cases may have inflammation of pancreas
Bleeding
Rarely a tear or perforation of the intestinal wall may occur
The latter two rare complications may require surgery
|
|