Reasons for ERCP
ERCP, or endoscopic retrograde cholangiopancreatography, is a medical procedure that can be both diagnostic and therapeutic. According to the American Society for Gastrointestinal Endoscopy (ASGE) primarily used to treat blockages of the bile ducts. Reasons for ERCP can include stones, tumors, inflammation, and other types of pancreaticobiliary disorders.
A benefit of ERCP is that diagnosis and treatment can take place during the same procedure. Conducting an ERCP can be more effective than certain other diagnostic procedures. However, it also carries higher risk factors than most diagnostic methods.
What are Bile Ducts?
In order to understand the reasons for ERCP, it is important to first understand the anatomy of the examined area. There are two main ducts that ERCP examines: the pancreatic duct and the common bile duct. These ducts are tube-like pathways that drain the liver, gallbladder, and pancreas.
The bile and pancreatic juice drained from the ducts are conveyed into the duodenum. The duodenum is the first portion of the small intestine. Common reasons for ERCP include a blockage of the common bile duct or pancreatic duct. This is often caused by gallstones, but may be caused by a series of other conditions.
ERCP for Bile Duct Blockage
The primary reasons for ERCP are the blockage or narrowing of one the bile ducts. This type of obstruction can be caused by many conditions. An ERCP procedure can be used as a diagnosis for these medical conditions as well as a treatment. ERCP is typically recommended for conditions during which the doctor suspects that treatment can be administered during the same diagnostic ERCP treatment.
Reasons for ERCP include bile duct blockage caused by:
- Infection that causes inflammation
- Strictures, or scarring
- Accumulations of tissue or fluid
- Cancerous or non-cancerous tumors
- Improperly functioning bile duct or organ sphincters
Reasons for ERCP include diagnosis of a medical condition involving the pancreas or bile ducts. During diagnosis, the doctor will use ERCP to examine the ducts and look for abnormalities including blockages, tissue irregularities, stones, tumors, and issues with the flow of pancreatic fluid or bile.
In many cases, bile duct stones can be removed using ERCP. Tumors can be both diagnosed and treated with ERCP. Treatment of tumors involves using the indwelling plastic tubes to bypass a bile duct blockage.
Symptomatic Reasons for ERCP
Reasons for ERCP include the evaluation of certain symptoms that suggest disease in the bile ducts or pancreas. An experienced doctor will be able to determine whether or not a patient’s symptoms indicate reasons for ERCP.
Symptoms indicating reasons for ERCP may include:
- Persistent abdominal pain not diagnosable by other tests
- Jaundice, or yellowing of skin and eyes
- Light colored stools or dark urine
- Loss of appetite or weight
- Confirmed diagnosis of certain cancers in the affected organs
- CT scan showing a stone or mass in the affected organs
“ERCP.” Medline Plus.U.S. National Library of Medicine, 22 Mar 2013. Web. 19 Jun 2013. <http://www.nlm.nih.gov/medlineplus/ency/article/007479.htm>.
“ERCP.” National Digestive Diseases Information Clearinghouse. U.S. Department of Health and Human Services, 29 Jun 2012. Web. 19 Jun 2013. <http://digestive.niddk.nih.gov/ddiseases/pubs/ercp/?control=Tools>.
“Laparoscopic Bile Duct Surgery.” USC Center for Pancreatic and Biliary Diseases. University of Southern California, Department of Surgery, n.d. Web. 19 Jun 2013. <http://www.surgery.usc.edu/divisions/tumor/pancreasdiseases/web pages/BILIARY SYSTEM/lap surg-bile duct.html>.
Loperfido, Silvano. “Patient information: ERCP.” UpToDate. Wolters Kluwer Health, 11 Jan 2013. Web. 19 Jun 2013. <http://www.uptodate.com/contents/ercp-endoscopic-retrograde-cholangiopancreatography-beyond-the-basics
“Patient Information for ERCP.” SAGES. Society of American Gastrointestinal and Endoscopic Surgeons, n.d. Web. 19 Jun 2013. <http://www.sages.org/publications/patient-information/patient-information-for-ercp-endoscopic-retrograde-cholangio-pancreatography-from-sages/>.
Simmons, Dia T, and Todd H Baron. “Perceptions on ERCP Utilization in the United States.” The American Journal of Gastroenterology 102.5 (2007): 976-977. MEDLINE with Full Text. Web. 19 June 2013.