reply-Jackie ERCP

[Guest guest]

Hi Jackie,

Here's the information Joanne posted about ERCP.

Maybe someone else has the info on MRCP. I've never

had either one, so I have no experience with it.

Barbara Ann

From: JJCATHCART@...

ERCP

ERCP stands for endoscopic retrograde

cholangiopancreatography. As hard as this is to say,

the actual exam is fairly simple. A dye is injected

into the bile and pancreatic ducts using a flexible,

video endoscope. Then x-rays are taken to outline the

bile ducts and pancreas.

The liver produces bile, which flows through the

ducts, passes or fills the gallbladder and then enters

the intestine (duodenum) just beyond the stomach.

The pancreas, which is six to eight inches long, sits

behind the stomach.

This organ secretes digestive enzymes that flow into

the intestine through the same opening as the bile.

Both bile and enzymes are needed to digest food.

Equipment

The flexible endoscope is a remarkable piece of

equipment that can be directed and moved around the

many bends in the upper gastrointestinal tract.

The newer video endoscopes have a tiny, optically

sensitive computer chip at the end. Electronic signals

are then transmitted up the scope to the computer

which then displays the image on a large video screen.

An open channel in the scope allows other instruments

to be passed through it to perform biopsies, inject

solutions, or place stents.

ERCP is used for:

Gallstones, which are trapped in the main bile duct

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Blockage of the bile duct

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Yellow jaundice, which turns the skin yellow and the

urine dark

Undiagnosed upper-abdominal pain

Cancer of the bile ducts or pancreas

Pancreatitis (inflammation of the pancreas)

Preparation

The only preparation needed before an ERCP is to not

eat or drink for eight hours prior to the procedure.

You may be asked to stop certain medications such as

aspirin before the procedure. Check with the

physician.

The Procedure

An ERCP uses x-ray films and is performed in an x-ray

room. The throat is anesthetized with a spray or

solution, and the patient is usually mildly sedated.

The endoscope is then gently inserted into the upper

esophagus. The patient breathes easily throughout the

exam, with gagging rarely occurring. A thin tube is

inserted through the endoscope to the main bile duct

entering the duodenum. Dye is then injected into this

bile duct and/or the pancreatic duct and x-ray films

are taken. The patient lies on his or her left side

and then turns onto the stomach to allow complete

visualization of the ducts. If a gallstone is found,

steps may be taken to remove it. If the duct has

become narrowed, an incision can be made using

electrocautery (electrical heat) to relieve the

blockage. Additionally, it is possible to widen

narrowed ducts and to place small tubing, called

stents, in these areas to keep them open. The exam

takes from 20 to 40 minutes, after which the patient

is taken to the recovery area.

Benefits

An ERCP is performed primarily to identify and/or

correct a problem in the bile ducts or pancreas. This

means the test enables a diagnosis to be made upon

which specific treatment can be given. If a gallstone

is found during the exam, it can often be removed,

eliminating the need for major surgery. If a blockage

in the bile duct causes yellow jaundice or pain, it

can be relieved.

Alternative Testing

Alternative tests to ERCP include certain types of

x-rays (CAT scan,CT) and sonography (ultrasound) to

visualize the pancreas and bile ducts. In addition,

dye can be injected into the bile ducts by placing a

needle through the skin and into the liver. Small

tubing can then be threaded into the bile ducts. Study

of the blood also can provide some indirect

information about the ducts and pancreas.

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