ERCP - Endoscopic Retrograde Cholangiopancreatography

ERCP - Dubai Gastroenterology Clinic

ERCP (Endoscopic Retrograde Cholangiopancreatography) is a procedure that helps investigate most pancreatic, biliary, hepatic, and gallbladder diseases, using a flexible, lighted fiberoptic endoscope (duodenoscope) which is passed from the mouth through the esophagus stomach, and finally into the first and second duodenum. Then, a cannula, which is a small plastic tube, is inserted through the scope and passed across the tiny muscular opening (sphincter) that leads into the pancreatic and liver ducts. A guidewire is inserted or contrast is injected through the cannula and x-rays are taken in order to study the ductal systems. If needed, during the procedure, a biopsy (a small sample of tissue) can be obtained via the scope and sent to the laboratory for further evaluation. Biopsies do not necessarily imply cancer.

Indications:

In case there is an obstruction to the flow of bile, an ERS (Endoscopic Retrograde Sphincterotomy) can be done as a treatment, in which, a  special cannula that has a cutting wire is passed through the tiny opening (sphincter) that leads into the bile ducts. The opening of this sphincter then is enlarged with this cutting wire, and after enlarging the opening, stones can be extracted into the small intestine, which will pass naturally and unnoticed along with the stools. Some larger stones may require to be either crushed with special equipment or removed with a tiny balloon or wire basket. In special cases, a small tube (called a stent) can be placed and left in the bile duct to allow free drainage of the bile. It can be either removed later or kept in place. In case the patient goes through therapeutic interventions then he will be admitted for observation.

Preparation:

• The procedure has to be done on an empty stomach (nothing to eat or drink after midnight).
• It is also done under anesthesia.
• Antiaggregants and anticoagulation are better to be stopped 1 week before the procedure if no contraindications.

Complications:

• ERCP is safe and it is also associated with low risk when it is performed by well-trained physicians
• However, in some cases, Pancreatitis could happen, where the pancreatic tissue can become inflamed secondary to the process by itself (cutting, injecting, and manipulating the ducts) only in ~ 3 to 10% of cases.
• Other much less common risks include perforation (tear) of the bowel in cases where sphincterotomy is needed, drug reactions, and complications from unrelated diseases such as heart attack or stroke.

The decision to perform an ERCP is based upon the assessment of the doctor to a particular problem.

Dubai Gastroenterology Clinic - Dr. Rami Hamed Center now provides the leading gastroenterologist in Dubai for Gastric Balloon, Colonoscopy, Colon Cancer Screening, and so on. DRHC offers highly qualified liver specialist doctors in Dubai with a wide range of services on liver failure, nonalcoholic fatty liver disease treatment, liver disease treatment, etc.