Dr. Ertan Beyatlı

What is ERCP? When is it done?

(Update: ) - Digestive System Diseases

ERCP is an acronym. ERCP stands for Endoscopic Retrograde Cholangiopancreatography. It refers to the process of examining the bile ducts, gall bladder and pancreatic gland from the liver to the intestines with a special and flexible instrument (endoscope). X-rays are taken during the procedure (x-ray scope).

During the procedure, an instrument (endoscope) is entered through the mouth and the esophagus, stomach and twelve-finger intestine are examined respectively. The process continues until the point where the bile ducts open to the small intestine (ampulla of vater, oddi sphincter).

It can cure some of the problems found during the ERCP process. An example of an abnormal occurrence (biopsy). It can remove the gallstones in the bile ducts, the strictures can be expanded, and a plastic tube (stent) can be inserted.

When is the ERCP process done?

ERCP process can be done in the following situations:

  • Continuous stomach pain or jaundice
  • Gallstones, liver, bile ducts and pancreatic diseases
  • Gallstones in removal, eg. Stones that cause obstruction, jaundice and inflammation in the biliary tract (cholangitis, pancreatitis)
  • Biliary strictures or a drainage (stent, drain) procedure.
  • Taking tissue samples for further examination (biopsy, pathology).
  • Measurement of pressure in the bile ducts (manometry).

Who does the ERCP process?

Endoscopic retrograde cholangiopancreatography (ERCP) is usually performed by a gastroenterologist. In addition, this procedure is performed by General Surgery and Internal Medicine specialists who have received special training in ERCP. ERCP is a specialized and invasive procedure, not just the Endoscopy procedure. Not every doctor who can perform endoscopy can do ERCP!

This process is done in hospital conditions. If your doctor develops gallstones or inserts a stent during the test, you may need to stay in the hospital overnight. Otherwise, you can go home after the test.

Pre / post preparations for the ERCP process Endoscopy are like preparations. In addition, some medications and antibiotics can be given before the procedure. A standard ERCP process usually takes 30 to 60 minutes. Patients are kept under observation for 1-2 hours after the procedure. There may be some temporary problems in the abdomen due to the gas given to the intestines after the procedure. pain, swelling, nausea, etc.

So, Are There Risks of ERCP Process?

The procedure must be performed by an experienced and competent physician. Complications are not common anymore, as preparations and controls have been made better in recent years. In the past, serious problems were experienced during and after the ERCP process. Although these problems are not common today, we can list these problems as follows:

  • Inflammation of the pancreas (this is called Pancreatitis): a very serious and risky complication.
  • Bleeding: It can be seen especially in enlargement of the pancreas or bile ducts or in stent placement or biopsy procedures.
  • Bile duct infection (also called Cholangitis): can occur when gallstones are removed.
  • An infection in the blood (this is called sepsis)
  • An abnormal heart rhythm (arrhythmia, tachycardia, bradycardia, AF)
  • Puncture or tear: Perforation or rupture of the esophagus, stomach, duodenum, bile duct, or pancreatic duct. Surgery will be required to repair this condition.
  • Problems caused by anesthesia.

After the test, call your doctor right away in these situations:

  • Extreme nausea or vomiting
  • New or increased belly pain
  • Fever or chills
  • Shortness of breath
  • Dizziness or fainting

How are Transaction Results evaluated?

As I explained at the beginning of my article, the liver, bile ducts, gall bladder and pancreatic gland are examined in the ERCP procedure. It also gives an idea about the upper digestive system since it is an endoscopy procedure. Your doctor can tell you about some of the findings right after the test. However, due to the effect of the drugs that relax you for the test, your doctor may tell you to call you for your results the next day. After the process, you will be given a detailed and visual report about the transaction.

Depending on the ERCP results, you may need other tests to confirm a diagnosis. These include angiography or laparoscopy.

If you have abdominal pain or jaundice before the procedure, your doctor may recommend a different costly or feasible and non-invasive test before ERCP, eg. ultrasound, CT, or MR.

Magnetic resonance cholangiopancreatogram (MRCPAn imaging test called MR Cholangio) can show the bile ducts and help diagnose medical conditions. However, no biopsy or treatment is performed during MRCP.

Endoscopic ultrasound (EUS) testing can help diagnose noncancerous (benign) or cancerous (malignant) tumors of the esophagus, stomach, pancreas, and bile ducts.

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