ERCP (Endoscopic Retrograde Cholangiopancreatography) method is to perform procedures such as removing stones from the gallbladder into the bile ducts, diagnosing tumors in the bile ducts and placing stents in the bile ducts for the treatment of jaundice due to obstruction. ERCP strong> It is a process that requires advanced experience. It is one of the endoscopic procedures with the highest risk of complications. For this reason, it is a procedure that must be performed by experienced gastroenterologists.
Stones in the gallbladder are common in the society. However, not every stone causes disease. For many, it is better to leave it alone than to undergo surgery. However, if these stones cause inflammation or block the duct, the gallbladder must be removed. Today, this procedure is usually performed with laparoscopic (closed) surgery. Before laparoscopic surgery, if there is a stone in the patient's biliary tract or if it is suspected (which is usually detected by the film called MRCP), then ERCP should be performed. ERCP can sometimes be performed under emergency conditions when the patient develops jaundice and fever.
ERCPoperation is performed through the mouth with an instrument similar to endoscopy, where the bile duct in the second part of the duodenum is opened. It is done by reaching the shaped area. After reaching this point, the bile ducts are entered in the reverse way (that is, by moving from the intestine to the bile duct, considering that bile flows towards the intestine) and the dyed substance is administered there. Meanwhile, an X-ray is taken to detect the presence of stones or masses in the bile duct. After this stage, the mouth of the canal is widened by cutting a few millimeters. Then, the stone(s) are removed with the help of tools we call a balloon or basket. When the procedure is performed on the right patient and for the right reason, it is a successful method that yields results very quickly.
The most important complication of ERCP is 2-5%after this procedure. >It is the most common inflammation of the pancreatic gland. It is generally more common in young people and women. It is mild in most patients, but can rarely be severe. There are various medications or methods such as stents to prevent this situation. The practitioner may choose one of these. Apart from these, bleeding and intestinal perforation may occur when making an incision. In these cases, the patient needs to undergo urgent surgery. But these complications occur in 1 in 1000 patients.
ERCPis a procedure performed with radiation, so its application in pregnant women varies slightly. During pregnancy, ERCP can be performed by making an incision without taking a film, removing stones with a balloon, or by placing a temporary stent in the bile ducts. Permanent treatment is performed when the pregnancy ends.
When the stone in the bile ducts is removed with ERCP, the patient must have gallbladder surgery for permanent treatment.
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