Endoscopic retrograde cholangio pancreatography(ERCP)
ERCP is technically challenging and advanced procedure for management of pancreatobiliary disease. ERCP is performed in left lateral, prone or supine position with patient sedated. Duodenoscope (Side viewing endoscope) is passed under vision to focus on ampulla in the second part of duodenum. Based on indication and patient problem, biliary or pancreatic duct is cannulated with the help of guide wire and Endotherapy is performed. In expert hands the procedure is safe but still has significant risks. Prior to procedure the gastroenterologist will discuss with the patient and their relatives the benefits, risks, alternatives and technical details of ERCP. Informed consent is taken from the patient about ERCP. The patient may require admission in a hospital prior to or after the ERCP for fitness or monitoring. Dr. Tarun Bharadwaj cures as an Endoscopist in Bhopal, having an experience of more than 10 years.
Indications for ERCP
With the availability of EUS and MRCP/CT scan, diagnostic ERCP is no longer performed. ERCP has following therapeutic indications-
- 1. CBD stone (Choledocholithiasis) extraction and stenting
- 2. Management of Post cholecystectomy bile leak
- 3. Plastic stenting or Covered metallic stenting for benign biliary stricture
- 4. Self expanding metallic stenting (SEMS) for unoperable Pancreato-biliary malignancies such as advanced gall bladder cancer, unresectable cholangiocarcinoma and pancreatic cancer.
- 5. Spy Cholangioscopy with LASER Lithotripsy for difficult/Large stones
- 6. Pancreatic stone removal and stenting for pain relief in chronic calcific pancreatitis
- 7. Pancreatic sphincterotomy and stenting for transpapillary peripancreatic fluid drainage
- 8. Pancreatic sphincterotomy and stenting for post traumatic pancreatitis and pancreatic ductal leak.
- 9. Pancreatic Endotherapy for recurrent acute pancreatitis in Pancreas divisum.
- 10. Removal of proximally migrated pancreato-biliary stents.
- 11. Plastic stenting in acute cholangitis for urgent biliary decompression