ERCP or endoscopic retrograde cholangiopancreatography is a procedure performed by Gastroenterologist in Karachi to diagnose and treat the conditions of the bile duct and pancreas. ERCP is a combination of endoscopy and X-rays to know exactly what is wrong with the patient. Read on to know more about this procedure:
What is ERCP?
ERCP is the procedure to look at the pathologies of the GI tract and look ‘upstream’ where digestive fluids come from—including pancreatic juice and bile. In addition to diagnosis, ERCP can help to perform small procedure like stent placement to relieve acute obstructions.
When is ERCP used?
ERCP is performed for the following:
- To diagnose any tumors of the liver or pancreas
- To diagnose any blockage or obstruction in the flow of pancreatic juice
- To diagnose blockage or stricture in the bile duct
- To diagnose and remove stones from the bile duct
- To diagnose and treat fluid leakage from the biliary or pancreatic ducts
What is the preparation procedure of ERCP?
Before the procedure of ERCP, the patient is sedated. Therefore, the preparation involves:
- Temporary cessation of certain medications that may interact with sedatives.
- For the day of the procedure, the patient is directed to drive home accompanied by someone and not drive alone for at least the following 24 hours.
- For at least six hours before the procedure, the patient is directed to not eat or drink anything, but drinking fluids is fine.
- Prior to the procedure, the patient should inform the healthcare provider about any allergies to medication like antibiotics or dyes etc. For patients with known allergies, antiallergic medication is taken to make the procedure safe for them.
- The healthcare provider should also be informed if the patient is taking medication like antiplatelets and blood thinners. These medications are recommended for people who have ischemic heart disease. Examples of such medication include: warfarin, heparin and aspirin.
- Pregnant patient should also inform their doctor about their pregnancy as certain sedative medication can harm the baby.
- Diabetic patients, especially on insulin, need to manage the dose of their medication on the day of the procedure with the help of the diabetologist.
- Patients with lung conditions should also inform their healthcare provider so they can evaluate the risk of sedation and anesthesia.
How is ERCP done?
For the procedure, a specialist healthcare provider called gastroenterologist uses a long, flexible tube called endoscope with a camera and light at the end to examine the digestive system. This scope is inserted into the bile duct and a special dye or contrast agent is injected at this point. Thereafter, images are taken with x-rays to view the pancreatic ducts, gall bladder and bile ducts.
If any problem is identified at this point, the healthcare provider uses ERCP to perform certain procedures. These include:
- Sphincterotomy: a small cut is made on the opening of the duct that is obstructed. This works to relieve any obstruction and help small stones—bile stone or gall stones—to pass. With this procedure, bile and pancreatic juice can flow freely.
- Gall stone removal: small gallstones from the bile duct can be removed with the help of ERCP. However, stones from the gall bladder cannot be removed through this procedure.
- Stent in the ducts: for strictures in bile or pancreatic ducts, stents can be placed. These stents allow free flow of the bile or pancreatic juice. Stents are easily placed with the help of ERCP.
- Biopsy sample: if any mass or tumor is present in the liver or pancreas, biopsy samples can be taken with the help of ERCP.
What are the complications of ERCP?
Even though it is considered a very safe procedure, complications may occur. These include:
- Perforation of bowels or nearby structures
When to seek help?
Patient should seek immediate help of the experts at Hameed Latif Hospital in case of:
- Black stools
- Severe abdominal pain
- Sore throat
Distention in the abdomen