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One-minute reading, Then you know ERCP more

Wednesday 25th April 2018 Back to list

One-minute reading, Then you know ERCP more

 

ERCP(Endoscopic Retrograde Cholangio-Pancreatography) is a procedure that enables physician to examine the pancreatic and bile duct. It took birth on late 60th. It was firstly reported on 1968. And in 1974, Kaiwai, Classen have reported EST operation firstly, which started the page of treatments under ERCP.  

Why is ERCP performed?

It is used to evaluate symptoms suggestive of disease in pancreas and bile duct, or to further clarify abnormal results from blood tests or imaging tests such as ultrasound or CT scan. The most common reasons to do ERCP include the abdominal pain, weight loss, jaundice or an ultrasound that shows stones or a mass in these organs.

ERCP may be used before or after gallbladder surgery to assist in the performance of that operation. Bile duct stones can be diagnosed and removed with an ERCP. Tumors, both cancerous and noncancerous, can be diagnosed and then treated with indwelling plastic tubes that are used to bypass a blockage of the bile duct. Complications from gallbladder surgery can also sometimes be diagnosed and treated with ERCP.

In patients with suspected or known pancreatic disease, ERCP will help determine the need for surgery or the best type of surgical procedure to be performed. Occasionally, pancreatic stones can be removed by ERCP.

ERCP in China

In China, bile duct stone is the common disease. It is widely proved by researches that ERCP is the best method to diagnose bile duct stone. While performed with ERCP, it displays turgor defect (obvious difference from the irregular stricture of the tumor ), stone location, size and quantity could be identified. Biopsy could be performed as well.

The sensitivity and specificity of ERCP diagnosis of common bile duct stone exceed 95%. The precise rate of common bile duct stone is 92.1% ~94.6%. The visualization ratio of hepatic duct is 6.6% and diagnosis accordance rate is 96.6%.

China has performed the first case ERCP since 1973. With the unremitting efforts in these 30 years, the successful rate of ERCP has rised to 96.1% from 84%.  The successful rate of EST stone retrieval under ERCP is over 90%.  The complications occurrence rate is 5%. The mortality rate is less than 1%.  

 

ERCP VS MRCP

With imaging technology development, MRCP has become the first choice of diagnosis for bile duct and pancreas diseases owing advantages of no trauma, no X-ray radiation, no contrast agent injection.

In comparison, MRCP has higher sensitivity in diagnosing choledochectasia. But it could not give precise evidence of causes of choledochectasia. The sensitivity of diagnosis for small stone on common bile duct are not as satisfying as ERCP.  The coincidence of malignant stricture is 71.43%.

Presently , MRCP could not replace ERCP in diagnosis of bile duct and pancreas diseases. The two sides complement with each other in practical use.

 

Disease that ERCP has advantages in diagnosis:

Bile duct stone

Malignant bile duct tumor

Obstructive jaundice

Sphincter of Oddi Dysfuunction

Chronic pancreatitis

Pancreatic cancer

Pancreatic congenital schism