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ERCP (cont.)

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What are the reasons for ERCP?

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:

  • Blockage of the bile duct by gallstones, cancer, strictures (scarring) or compression from adjacent organs or tumors
  • 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
  • Confirming the diagnosis of cancer of the pancreas or the bile duct, so that surgery or other treatment can be tailored to the disease
  • When there is suspicion that the Sphincter of Oddi within the Papilla of Vater, that controls the flow of bile and pancreatic juice, is not working normally (Sphincter of Oddi dysfunction)

What are the side effects and complications of ERCP?

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 with very experienced physicians. This "injection" pancreatitis usually is treated in the hospital for one to two days. Another possible complication is infection. Other serious risks including perforation of the intestine, drug reactions, bleeding, depressed breathing. Irregular heart beat or heart attack are extremely rare. In case of complications, patients need to be hospitalized, but surgery rarely is required.

In summary, ERCP is a straight-forward but skill-requiring outpatient examination that is performed with the patient sedated. The procedure provides important 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 surgery can be avoided. ERCP, combined with endoscopic ultrasonography, is currently the diagnostic and therapeutic procedure of choice in most patients for identifying and removing gallstones in the bile ducts.

REFERENCE: Endoscopic Retrograde Cholangiopancreatography.


Medically Reviewed by a Doctor on 4/27/2012

Source: MedicineNet.com
http://www.medicinenet.com/ercp/article.htm

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