ERCP is a medical technique that uses an endoscope to diagnose problems in the pancreatic or bile ductal systems. The procedure is done under light anesthesia and uses fluoroscopy and angiography to monitor for blockages. Risks include pancreatitis, perforation, and allergic reactions.
ERCP stands for endoscopic retrograde cholangiopancreatography, a medical technique used to diagnose specific problems of the pancreatic or bile ductal systems. The different types of ERCP procedures focus on an endoscopic look at the bile ducts of the pancreas, gallbladder, and the part of the bile duct tree that interfaces with the liver. In close proximity to these anatomical structures, the ERCP endoscope can remove a sphincter from the biliary system, remove gallstones, or place stents. These ERCP procedures are usually done under light anesthesia with the use of endoscopy, fluoroscopy, and angiography to monitor for blockages in the biliary tree.
For any ERCP procedure, the patient lies on their left side, usually lightly sedated and anesthetized. This procedure uses an endoscope, which is a small camera on the end of a long, flexible tube, and is passed through the mouth and guided down the esophagus into the stomach. It passes from the stomach to the beginning of the small intestine, known as the duodenum. It is where the openings to the common pancreatic and bile ducts are located.
One of the distinguishing features of ERCP procedures is the use of fluoroscopy. Fluoroscopy is a special type of X-ray that allows your doctor to see structures in your body in real time. Angiography is also used to show the vessels and ducts of the gallbladder and pancreas.
Using these instruments, the doctor will highlight the biliary tree to see if there are any blockages or strictures that need to be addressed. From this point, the doctor can use the endoscope to troubleshoot problems by dilating a stricture, placing a stent, or removing a stone. During this time, the patient sleeps and will not remember anything about the procedure. Vital signs are closely monitored and the patient continues to sleep.
There are some risks with ERCP procedures, such as pancreatitis. Pancreatitis is characterized by severe abdominal pain, nausea and vomiting. While it’s a risk with ERCP procedures, it’s also a risk of gallstones and biliary strictures. The risk of pancreatitis from an ERCP is about 5%. Other risks include perforation of the small intestine and an allergic reaction to the iodine-containing contrast agent used for the imaging segment of the procedure.
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