ERCP (Endoscopic Retrograde Cholangiopancreatography) Overview

ERCP (Endoscopic Retrograde Cholangiopancreatography) Overview

What is ERCP? Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscopea long, flexible, lighted tube.

What are the indications of ERCP?

ERCP indications include obstructive jaundice, biliary or pancreatic ductal system disease treatment or tissue sampling, suspicion for pancreatic cancer, pancreatitis of unknown cause, manometry for sphincter of Oddi, nasobiliary drainage, biliary stenting for strictures and leakage, drainage of pancreatic pseudocysts, …

What is the difference between ERCP and endoscopy?

They are relatively similar to each other as both involve the use of an endoscope. The main difference between the two is that endoscopic ultrasound utilizes high-frequency sound waves to generate a virtual image and ERCP procedure uses a video camera.

How is ERCP used in diagnosis and how ERCP use as therapeutic?

ERCP is a procedure that doctors use to diagnose and sometimes treat a blockage or restriction of the pancreatic or bile ducts. During an ERCP, a tube is inserted into the patient’s mouth, and then passed through the esophagus, stomach, and into the opening of the small intestine.

What are the benefits of ERCP?

ERCP offers the following advantages: Allows treatment of obstruction using sphincterotomy, stone extraction, stent placement, or balloon-dilation of strictures. Permits biopsies under direct visualization. Provides excellent visualization of the bile ducts.

Is ERCP a high risk surgery?

Because ERCP is a high-risk procedure, the indication for ERCP, especially in cases of asymptomatic CBDS, should be determined after careful consideration of the risks and benefits of the treatment.

What are the side effects of a ERCP?

ERCP Side Effects
  • Severe, worsening abdominal pain.
  • A distended, firm abdomen.
  • Fever or chills.
  • Vomiting, especially vomiting blood.
  • Difficulty swallowing or breathing.
  • Severe sore throat.

Is an ERCP painful?

This procedure is typically done in an outpatient setting, and you shouldn’t experience pain or discomfort during an ERCP because it’s done with anesthesia sedation.

Is ERCP a surgery?

Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscopea long, flexible, lighted tube.

Are you awake during ERCP?

ERCP is usually an outpatient procedure, which means you go home the same day. The procedure can take one to two hours. You’ll receive IV anesthesia (medicine to calm you). You’ll be awake for the procedure, but you probably won’t remember any of it.

What is the most common complication of ERCP?

Pancreatitis (inflammation of the pancreas) is the most frequent complication, occurring in about 3 to 5 percent of people undergoing ERCP. When it occurs, it is usually mild, causing abdominal pain and nausea, which resolve after a few days in the hospital. Rarely pancreatitis may be more severe.

How long does pain last after ERCP?

The referred pain usually lasts less than 12 hours. You may have a small amount of bleeding from the puncture site. You will need to take it easy at home for 1 to 3 days after the PTC. You will probably be able to go back to work and most of your usual activities after that.

Which one of the following conditions may contraindicate an endoscopic retrograde cholangiopancreatography?

Structural abnormalities of the esophagus, stomach, or small intestine may be relative contraindications for ERCP. Examples are acquired conditions such as esophageal stricture, paraesophageal herniation, esophageal diverticulum, gastric volvulus, gastric outlet obstruction, and small-bowel obstruction.

How is a ERCP done?

During an ERCP, the doctor uses a special narrow, flexible tube (endoscope) that has a video camera. While the child is asleep, the tube is placed through the child’s mouth into the upper digestive system. Contrast dye with X-rays allow the doctor to see stones, abnormal narrowing or blockages in the ducts.

How much is ERCP in the Philippines?

The cost of endoscopy in the Philippines may start from Php 6,000 to Php 15,000 or more. Some people may opt for an anesthesia during the procedure which will make the cost higher.

What is difference between MRCP and ERCP?

MRCP was developed in 1991 and techniques are continuing to improve. A major feature of MRCP is that it is not a therapeutic procedure, while in contrast ERCP is used for both diagnosis and treatment. MRCP also does not have the small but definite morbidity and mortality associated with ERCP.

Is ERCP an emergency?

Emergency ERCP is feasible, safe and effective in critically ill patients with acute severe cholangitis in appropriate settings. Emergency ERCP is successful and results in a good outcome in this cohort of critically ill patients. Emergency ERCP in this cohort of critically ill patients should not be considered futile.

Who is at risk with an ERCP?

Independent risk factors for post-ERCP pancreatitis were identified as a history of recurrent pancreatitis, previous ERCP-related pancreatitis, multiple cannulation attempts, pancreatic brush cytology, and pain during the procedure.

Does ERCP remove gallstones?

ERCP can remove gallstones from the bile duct, but not from the gallbladder itself.

What happens if ERCP fails?

When ERCP fails because of the inability to cannulate the bile duct or malignant obstruction of the duodenum, where papilla are not accessible, PTBD has been the alternative therapy. Although PTBD has been proven very useful in the past, the decision to apply EUS must be considered very carefully.

Is it normal to bleed after ERCP?

Postsphincterotomy bleeding has been reported in up to 2% of ERCP cases. Immediate bleeding is seen in up to 30% of patients. Delayed bleeding can occur up to 2 weeks after the procedure. Several studies have addressed the risk factors for bleeding after endoscopic sphincterotomy.

How do I prepare for an ERCP?

  1. You may have diet and/or medication restrictions the week before the ERCP test. …
  2. You will not be allowed any heavy meal for at least 8 hours before the procedure, light meals or opaque liquids for 6 hours before, or clear liquids for at least 2 hours before.
  3. Plan to take the day off from work.

Is vomiting normal after ERCP?

You may have bloating or nausea for a short time after the procedure. You may have a sore throat for 1 to 2 days. You can go back to a normal diet once your swallowing has returned to normal. You should rest at home for the remainder of the day.

Can you drink alcohol after an ERCP?

Drinking Alcohol after ERCP

Doctors usually recommend abstaining from alcohol completely for at least two days after ERCP. Drinking heavily or frequently can increase the risks of many health conditions. To stay healthy and avoid risky procedures like ERCP, limit your alcohol consumption or abstain completely.

How long after ERCP can you eat?

Since the pancreas plays a role in digestion, eating after an ERCP may contribute to complications such as pancreatitis. The recommendation time for a clear liquid diet varies. Some physicians recommend a clear liquid diet for 24 hours after the procedure. However, some physicians recommend it for 12 hours or less.

How are gallstones removed from bile duct?

Bile duct stones are typically removed using endoscopic retrograde cholangiopancreatography (ERCP), a minimally invasive procedure that combines x-ray and upper endoscopyan exam of the upper gastrointestinal tract, consisting of the esophagus, stomach and duodenum (the first part of the small intestine)using an …

What is T tube used for?

T Tube is a draining tube placed in the common bile duct after common bile duct (CBD) exploration with supra-duodenal choledochotomy. It provides external drainage of bile into a controlled route while the healing process of choledochotomy is maturing and the original pathology is resolving.

How long does an ERCP procedure take?

ERCP usually lasts thirty minutes to an hour. Your procedure might take more or less time depending on what your doctor needs to learn and do. You can talk with your doctor ahead of time about how long it might take.

Is diarrhea normal after ERCP?

Your doctor will tell you when you can take fluids and meals. Usually, it is within a few hours after the procedure. Because of the air used during ERCP, you may continue to feel full and pass gas for awhile, and it is not unusual to have soft stool or other brief changes in bowel habits.

Is a blocked bile duct an emergency?

If the blockage is not corrected, it can lead to life-threatening infection and a dangerous buildup of bilirubin. If the blockage lasts a long time, chronic liver disease can result. Most obstructions can be treated with endoscopy or surgery. Obstructions caused by cancer often have a worse outcome.

Is anesthesia given during ERCP?

ERCP is an uncomfortable procedure requiring adequate sedation or general anesthesia. The required level of sedation during these procedures is often deep. The patient cooperation is an imperative factor for the success of the procedure especially, to avoid intra-operative complications such as duodenal perforations.

Is it normal to be sore after an ERCP?

Most ERCPs are done without any problems. Some people have a mild sore throat for a day or so afterwards. You may feel tired or sleepy for several hours, caused by the sedative.

Do bile duct stents hurt?

Do biliary stents cause pain? Occasionally, stents can cause discomfort when placed, which might disappear after a few days. However, the stent may sometimes result in inflammation of the pancreas (pancreatitis). This can result in back pain.

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