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ERCP内镜下逆行胰胆管造影

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发表于 2013-2-6 14:53:10 | 显示全部楼层 |阅读模式

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ERCP : Endoscopic retrograde cholangiopancreatography

                               
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What's ERCP?
ERCP can be used primarily to identify and treat conditions of the bile ducts, including gallstones, inflammatory strictures, leaks (from trauma and surgery), and cancer. ERCP combines the use of x rays and an endoscope, which is a long, flexible, lighted tube. Through the endoscope, the doctor can see the interior of the stomach and duodenum, and inject dyes into the ducts within the biliary tree and pancreas to allow them to be seen on x rays.
Endoscopic retrograde cholangiopancreatography, or ERCP, is a specialized technique used to study the bile ducts, pancreatic duct and gallbladder. Ducts are discharge routes; the drainage channels in the liver are known as bile or biliary ducts. The pancreatic duct may be the drainage channel in the pancreas.

What preparation is needed?
A patient should fast for at least six hours before the procedure to carry on he/she should come with an empty stomach that is necessary for the best examination. A patient’s physician provides him/her with specific guidelines about how to prepare. Patient should speak to his/her physician about medicines he/she is taking regularly and any allergies patient need medicines or to intravenous contrast material. Although an allergic reaction doesn’t prevent a patient from having ERCP, it’s important to talk to physician before the procedure, since a patient may require specific allergy medicines prior to the ERCP. Tell physician about medications particular patient is taking, especially aspirin products, arthritis medications, anticoagulants, clopidogrel or insulin. Also, make sure to tell physician for those who have heart or lung conditions or other major diseases which might reduce or impact the decision to perform endoscopy.

What can I expect to have after ERCP?
For those who have ERCP as an outpatient, you will be observed for difficulties until the majority of the results of the medications have worn off before being sent home. You may experience bloating or pass gas because of the air introduced during the examination. You can resume your normal diet if you don't are advised otherwise.
Special instruments can be placed through the endoscope and into the ducts
  • Can open the entry of the ducts into the bowel
  • Can stretch out narrow segments
  • Can remove or crush stones
  • Can take tissue samples
  • Can drain blocked areas
Someone must accompany you home after the procedure due to the sedatives used throughout the assessment. Even if a patient feels alert after the procedure, the sedatives can affect his/her   reasoning and reflexes throughout the day.
Because individual conditions may vary, this brochure may not answer all your questions. Whatever you don’t understand please ask your doctor about.

How is ERCP performed?

During ERCP, your doctor will pass an endoscope through the mouth area, esophagus and stomach to the duodenum. An endoscope is really a thin, flexible tube that lets your physician see within your bowels. After physician views the most popular opening to the ducts from the liver and pancreas, known as the major duodenal papilla, doctor will pass a narrow plastic tube known as a catheter with the endoscope and to the ducts. A patient’s physician will inject a contrast material to the pancreatic or biliary ducts and can take X-rays.

So what can I expect in the course of ERCP?

Physician might use an area anesthetic to your throat and/or give you a sedative to help you much more comfortable. Your physician might even ask an anesthesiologist to manage sedation in case your procedure is complex or lengthy. Some patients also receive antibiotics prior to the procedure. You'll lie in your abdomen on an X-ray table. The instrument does not hinder breathing; however, you might feel a bloating sensation because of the air introduced with the device.
What exactly are possible complications of ERCP?

ERCP is a well-tolerated procedure when performed by doctors who're specially trained and experienced in the technique. Although difficulties requiring hospitalization can occur, they are uncommon. Complications range from pancreatitis, infections, bowel perforation and bleeding. Some patients might have an adverse reaction to the sedative used. Sometimes the process can't be completed for technical reasons. Risks vary, based on why the test is conducted, what's found during the procedure, what therapeutic intervention is undertaken, and whether a patient has major medical problems. Patients undergoing therapeutic ERCP, such as for stone removal, face a higher risk of complications than patients undergoing diagnostic ERCP. Your physician will discuss your probability of difficulties before you decide to undergo the test.

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