Endoscopic Retrograde Cholangiopancreatography is used for the diagnostic and therapeutic study of the biliary tract and pancreas. It combines endoscopy with radiology to be performed. It is also called, by its abbreviated acronym, ERCP or ERCP (Endoscopic Retrograde Cholangiopancreatography).
It is an endoscopic technique performed by specialists in gastroenterology-digestive endoscopy and digestive system, as well as experts in endoscopic nursing, anesthesiology and radiologists.
What can Endoscopic Retrograde Cholangiopancreatography detect?
The technique makes it possible to determine and detect alterations and/or lesions, such as deformities, lithiasis (stones), tumors or stenosis (narrowing) in the biliary and/or pancreatic ducts. Depending on the pathologies detected, the study may be completed with cytology or biopsies and/or endoscopic therapeutic intervention.
When should Endoscopic Retrograde Cholangiopancreatography be performed?
The main therapeutic indications for performing Endoscopic Retrograde Cholangiopancreatography are:
- Tumors of the biliary and/or pancreatic duct.
- Lithiasis or stones in the biliary and/or pancreatic duct.
- Stenosis due to pathologies, medical or post-surgical.
- Dysfunction of the sphincter of Oddi.
- Pseudocysts of the pancreas
- Pancreas divisum
Procedures performed with Endoscopic Retrograde Endoscopic Cholangiopancreatography
There are a series of procedures that are performed with this technique, to detect certain pathologies:
- Papillotomy or sphincterotomy. It acts at the mouth of the biliary and pancreatic ducts. It allows the introduction, a posteriori, of therapeutic instruments, as well as facilitating stone extraction.
- Extraction of lithiasis with balloon. It is indicated to remove stones from the biliary tract. It is performed with a cannula that is introduced and is equipped with a balloon at the distal end. When the deflated balloon passes through the bile duct until it passes over the stone, it is progressively inflated and withdrawn through the duct, until the stone is removed with a previously performed sphincterotomy.
- Extraction of lithiasis with basket. Depending on the characteristics of the lithiasis, other instruments are used, a catheter with a deployable crest that is introduced into the biliary tract and which, with an opening and closing technique, is inserted inside the stone. Once inside and the calculus trapped, the ridge is closed and extracted with the sphincterotomy already performed previously.
- Lithotripsy. In cases of larger stones that cannot be extracted through the orifice of the previous sphincterotomy, an attempt will be made to fragment them with other endoscopic material. Sometimes, due to the size and hardness of the lithiasis, surgical extraction will be indicated.
- Dilatation. In biliary and pancreatic duct stenosis, endoscopic treatment can be used to try to dilate the ducts, which may be due to benign or malignant pathologies. After endoscopic dilatation it may be necessary to place a prosthesis or stent in the dilated area to maintain the patency of the duct.
- Prosthesis placement. Prostheses or stents for the biliary or pancreatic duct are equipped with advanced technology. Their function is to drain the duct due to a pathology or stenosing process. They are indicated in benign stenosis as well as in neoplastic pathologies.