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Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is primarily performed by highly skilled and specialty trained gastroenterologists.
During ERCP the endoscopist may surgically widen the opening into the bile duct and remove the stone through that opening. ERCP, however, is an invasive procedure and has its own potential complications. Thus, if the suspicion is low, the physician may choose to confirm the diagnosis with MRCP, a non-invasive imaging technique, before ...
Endoscopic retrograde cholangiopancreatography (ERCP). Although this is a form of imaging, it is both diagnostic and therapeutic, and is often classified with surgeries rather than with imaging. Primary cholangiography (or perioperative): Done in the operation room during a biliary drainage intervention.
Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. [1] In 2011, cholecystectomy was the eighth most common operating room procedure performed in hospitals in the United States. [2] Cholecystectomy can be performed either laparoscopically, or via an open surgical technique. [3] [page needed]
In cholecystectomy there is a slight risk (0.3–0.5%) of injury of the bile ducts, most commonly of the common bile duct. [6] This complication can range from mild forms, which are easy to address during the operation, to more severe forms. [6] If not addressed such injury can be debilitating and lead to considerable morbidity. [6]
It remained a condition generally treated by surgeons, with exploration of the bile duct and excision of gallstones, until the ascendancy of ERCP in 1968. [25] ERCP is generally performed by internal medicine or gastroenterology specialists. In 1992 it was shown that ERCP was generally safer than surgical intervention in ascending cholangitis. [26]
Stones in the common bile duct can be removed before surgery by endoscopic retrograde cholangiopancreatography (ERCP) or during surgery. [7] Complications from surgery are rare. [4] In people unable to have surgery, gallbladder drainage may be tried. [5] About 10–15% of adults in the developed world have gallstones. [5]
Risks of cholecystectomy. [11] [52] [53] Obstruction of the common bile duct with gallstones can sometimes be relieved by endoscopic retrograde sphincterotomy (ERS) following endoscopic retrograde cholangiopancreatography (ERCP). [54] Risks of ERCP. [55]