Overview of Endoscopic Retrograde Cholangiopancreatography (ERCP)

Submitted by Nic on October 17, 2012

An endoscopic retrograde cholangiopancreatography is recommended for patients when doctors suspect that there may be a narrowing of the bile duct or a tumor or gall stones obstructing the bile duct. Referred to in short as the ERCP test, it is a procedure that is used for diagnosing diseases in the bile duct, duodenum, gallbladder, and pancreas. Test results may be useful to explain upper abdominal pain, sudden weight loss, or point to the reasons for jaundice. An endoscope, which is a long flexible tube with a lens and a light source, is fitted with X-ray capability and introduced into the body through the mouth. It is guided down the digestive tract until the endoscopist, who is a doctor trained in the use of the instrument, can see inside the stomach and the duodenum. The images are magnified on a monitor so that the doctor can see even minor details and note any abnormalities so as to treat the patient accordingly. The ducts of the biliary system and the pancreas open into the duodenum, and when the doctor injects a dye into the ducts, they become clearly visible and X-rays can be taken immediately.

In most patients with common bile duct or pancreatic diseases, endoscopic retrograde cholangiopancreatography is often used to diagnose and treat the condition by removing the gallstone obstructing the duct. The endoscopist may also place a stent to widen a narrowing duct. The procedure may also be used to extract tissue samples for a biopsy in case of tumors. Fluid blocked in the ducts may also be drained from cysts or and obstructions may be removed during this procedure. In case of such a procedure, the gastrointestinal endoscopy code takes an add-on endoscopic retrograde cholangiopancreatography CPT Code.

Although it is a safe and relatively risk-free procedure for most of the patients, endoscopic retrograde cholangiopancreatography complications include pancreatitis or inflammation of the pancreas and allergic reactions to the dye such as nausea. If the procedure involves removal of obstruction or stones or the insertion of a stent, there may be an added risk of perforation of the wall of the intestine. Some patients may have throat spasms or have a dry mouth and throat for a short period of time because the endoscope is introduced through the mouth. However, endoscopic retrograde cholangiopancreatography costs being lower make it an attractive alternative to surgery, for non-surgical management of a number of pancreatic and biliary disorders.

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