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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.
However, the Mayo Clinic has reported significant success treating early bile duct cancer with liver transplantation using a protocolized approach and strict selection criteria. [71] Adjuvant therapy followed by liver transplantation may have a role in treatment of certain unresectable cases. [72]
A Klatskin tumor (or hilar cholangiocarcinoma) is a cholangiocarcinoma (cancer of the biliary tree) occurring at the confluence of the right and left hepatic bile ducts. The disease was named after Gerald Klatskin, who in 1965 described 15 cases and found some characteristics for this type of cholangiocarcinoma. [1] [2] [3]
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.
Diagnosis and treatment can be carried out by an ERCP, where the accumulated debris identified in the blind end of the CBD is then extracted. [ 5 ] [ 21 ] Alternative treatment procedures include making an incision in the major duodenal papilla to enlarge the bile duct opening (biliary sphincterotomy).
The IVC has been largely replaced by other diagnostic procedures—by ERCP (endoscopic retrograde cholangiopancreatography), endoscopic ultrasound and, increasingly, by MRI cholangiography, none of which are affected by jaundice. It is sometimes used when ERCP is unsuccessful.
MRCP has been slowly replacing endoscopic retrograde cholangiopancreatography (ERCP) as investigation of choice. MRCP is highly accurate in diagnosing the biliary system, pancreatic duct and accessing surrounding solid organs. Several advantages offered by MRCP is its non-invasive nature, less costly, requires less examination time when ...