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Therapeutic Pancreatic Biliary Endoscopy (ERCP)

Therapeutic endoscopic retrograde cholangiopancreatography (ECRP) a procedure using an endoscope to view and treat complications of the pancreas, gallbladder, and bile ducts. Dr. Cofrancesco and Dr. Quijano can use the endoscope in conjunction with an x-ray machine for diagnostic purposes (such as testing for pancreatic cancer) or with other tools to solve problems associated with pancreatitis, gallstones, or narrow bile ducts.

To learn more about ECRP, continue reading below.

  • What is therapeutic pancreatic biliary endoscopy?
  • How should I prepare for therapeutic pancreatic biliary endoscopy?
  • How is therapeutic pancreatic biliary endoscopy performed?
  • What is the recovery time from therapeutic pancreatic biliary endoscopy?
  • What are the risks associated with therapeutic pancreatic biliary endoscopy?
  • Points to Remember

What is therapeutic pancreatic biliary endoscopy?

Therapeutic endoscopic retrograde cholangiopancreatography (ECRP) is a specialized technique used to view the pancreas, gallbladder, and bile ducts and treat complications of acute and chronic pancreatitis, gallstones, narrowing or blockage of the pancreatic duct or bile ducts, leaks in the bile ducts, and pseudocysts (accumulations of fluid and tissue debris).

After you are sedated by an anesthesiologist, Dr. Cofrancesco or Dr. Quijano will insert an endoscope (a long, flexible, lighted tube with a camera) through the mouth, esophagus, and stomach into the small intestine. The endoscope is connected to a computer and screen. Dr. Cofrancesco or Dr. Quijano guides the endoscope and injects a special dye into the pancreatic or bile ducts that helps the pancreas, gallbladder, and bile ducts appear on the screen while x rays are taken and procedures are performed.

How should I prepare for therapeutic pancreatic biliary endoscopy?

You should not eat or drink anything at least six hours before the procedure. You will need to let Dr. Cofrancesco or Dr. Quijano know of any medications you are currently taking including blood thinners and anti inflammatory drugs such containing aspirin. You may need to suspend or modify the use of such medications in advance of procedure.

If you use insulin for diabetes, Dr. Cofrancesco or Dr. Quijano may adjust your dosage the day of the test. Do not discontinue the use of any medication without speaking with Dr. Cofrancesco or Dr. Quijano first.

You will not be able to drive yourself home after the procedure. Arrangements for transportation home should be made prior to the procedure.

How is therapeutic pancreatic biliary endoscopy performed?

During ECRP, Dr. Cofrancesco or Dr. Quijano will pass an endoscope through your mouth, esophagus, and stomach and into the small intestine. To diagnose a problem, Dr. Cofrancesco or Dr. Quijano will inject a special dye into the pancreatic or bile ducts to helps the pancreas, gallbladder, and bile ducts appear on the screen while x rays are taken. To treat an issue with the pancreas, gallbladder, and bile ducts, a number of procedures can be performed using ERCP.

Sphincterotomy. Using a small wire on the endoscope, Dr. Cofrancesco or Dr. Quijano finds the muscle that surrounds the pancreatic duct or bile ducts and makes a tiny cut to enlarge the duct opening. When a pseudocyst is present, the duct is drained.

Gallstone removal. The endoscope is used to remove pancreatic or bile duct stones with a balloon or crushed with a basket. Gallstone removal is sometimes performed along with a sphincterotomy.

Stent placement. Using the endoscope, Dr. Cofrancesco or Dr. Quijano places a tiny piece of plastic or metal that looks like a straw in a narrowed pancreatic or bile duct to keep it open.

Balloon dilatation. Some endoscopes have a small balloon that Dr. Cofrancesco or Dr. Quijano can use to dilate, or stretch, a narrowed pancreatic or bile duct. A temporary stent may be placed for a few months to keep the duct open.

Tissue sampling. Using an endoscope, Dr. Cofrancesco or Dr. Quijano can take tissue samples from the bile or pancreatic ducts. The samples can then be tested to see if narrow ducts have been caused by cancer or another disorder.

What is the recovery time from therapeutic pancreatic biliary endoscopy?

While you will need someone to drive you home after the procedure, you should be able to resume a normal diet the same day. You will likely experience some minor discomfort from bloating and gas for several hours after the procedure.

What are the risks associated with therapeutic pancreatic biliary endoscopy?

If you undergo therapeutic ERCP, you are at slight risk for complications, including severe pancreatitis, infection, bowel perforation, or bleeding. Complications of ERCP are more common if you suffer from acute or recurrent pancreatitis. If you experience fever, trouble swallowing, or increased throat, chest, or abdominal pain after the procedure, you should Dr. Cofrancesco or Dr. Quijano immediately.

Points to Remember

  • Therapeutic endoscopic retrograde cholangiopancreatography (ECRP) is a specialized technique used to view and treat the pancreas, gallbladder, and bile ducts.
  • To prepare for therapeutic ECRP, you should fast for at least six hours and follow the specific medication guidelines that Dr. Cofrancesco and Dr. Quijano will create for you.
  • Therapeutic ECRP can be used for a number of procedures including sphincterotomy, gallstone removal, stent placement, balloon dilatation, and tissue sampling.
  • If you suffer from acute or recurrent pancreatitis, you are more likely to experience complications from therapeutic ERCP.

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