ERCP (cont.)
What are the reasons for the examination?
The liver, bile ducts, gallbladder, pancreas and the papilla of Vater
can be involved in numerous diseases, causing myriad of symptoms. ERCP is
used in diagnosing and treating the following conditions:
- Gallstones in the bile duct
- Blockage of the bile duct by stones, cancer,
stricture or compression from adjacent organs
- Jaundice (yellow coloring of the skin) due to
obstruction of the bile duct, also causing darkening of the urine and light
colored stool.
- Persistent or recurrent upper abdominal pain which
cannot be diagnosed by other tests
- Unexplained loss of appetite and weight loss
- Confirming the diagnosis of cancer of the pancreas or the bile duct,
so that surgery or other treatment can be tailored
What are the side effects and risks of the procedure?
ERCP is a highly specialized procedure which requires a lot of
experience and skill. The procedure is quite safe and is associated with a
very low risk when it is performed by experienced physicians. The success
rate in performing this procedure varies from 70% to 95% depending on the
experience of the physician. Complications can occur in approximately one
to five percent depending on the skill of the physician and the underlying
disorder. The most common complication is pancreatitis which is due to
irritation of the pancreas and can occur even in very experienced
physicians. This " injection " pancreatitis is usually treated
in the hospital for one to two days. Another possible complication is
infection. Other serious risks including perforation of the bowel, drug
reactions, bleeding, depressed breathing, irregular heart beat or heart
attack are extremely rare. In case of complication, patient needs to be
hospitalized and surgery is rarely required.
In summary, ERCP is a rather simple outpatient examination that is performed
with the patient sedated. The procedure provides significant information
upon which specific treatment can be tailored. In certain cases,
therapy can be performed at the same time through the duodenoscope, so
that traditional open surgeries can be avoided. ERCP is currently the
diagnostic and therapeutic procedure of choice in most patients for
identifying and removing gallstones in the bile ducts.
Endoscopic Retrograde Cholangio-Pancreatography at a Glance
- ERCP is a diagnostic procedure to examine diseases of
the liver, bile ducts and pancreas.
- ERCP is performed under intravenous sedation, usually
without general anesthesia.
- ERCP is an uncomfortable but not painful procedure.
There is a low incidence of complications.
- ERCP can provide important information that cannot be
obtained by other diagnostic examinations, e.g. abdominal ultrasound, CT scan,
endoscopic ultrasonography (EUS), or MRI.
- Frequently, therapeutic measures can be performed at the time of ERCP
to remove stones in the bile ducts or to relieve obstructions of the
bile ducts.
Last Editorial Review: 4/24/2002
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