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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.
The benefit of ERCP is that it can be utilized not just to diagnose, but also to treat the problem. 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.
Biliary endoscopic sphincterotomy is sometimes used, with or without stenting, to relieve the obstruction, but systematic reviews have not demonstrated consistent benefits. [ 5 ] Treatment of sphincter of Oddi dysfunction: this is a diagnosis of exclusion which encompasses a broad spectrum of hepatobiliary disorders including spasms, strictures ...
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]
Magnetic resonance cholangiopancreatography (MRCP) is a medical imaging technique. It uses magnetic resonance imaging to visualize the biliary and pancreatic ducts non-invasively. This procedure can be used to determine whether gallstones are lodged in any of the ducts surrounding the gallbladder.
SEMS are used to treat additional complications of cancer, such as tracheoesophageal fistulas from esophageal cancer, [8] and gastric outlet obstruction from stomach, duodenal, or pancreatic cancer. [9] SEMS and self-expanding plastic stents have also been used for non-malignant conditions that cause narrowing or leaks of the esophagus or colon.
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The technique involves the use of a balloon at the end of a special enteroscope camera and an overtube, which is a tube that fits over the endoscope, and which is also fitted with a balloon. [2] The procedure is usually done under general anesthesia , but may be done with the use of conscious sedation . [ 3 ]