March 27, 2009 § 1 Comment

An internist watching the x-ray screens during an ERCP.

A gastroenterologist watching the monitors during an ERCP.

A video I’ve made of endoscopic retrograde cholangiopancreatography (ERCP) was published on yesterday. This is an endoscopic procedure used both for diagnosis and treatment of pancreatic-, gallbladder- and bile duct cancer.

The patient is placed in the prone position. A duodenoscope, which has a sideways-facing camera and working channel, is used to locate the ampulla of Vater – where the joint common bile duct and pancreatic duct enters the duodenum.

A catheter is inserted into the ampulla, via the working channel of the scope, and is moved up into the bile duct. Radiocontrast is injected and the biliary ductal system is visualized using a fluoroscope. This patient has multiple blockages of the ducts, caused by infections.

A guide-wire is inserted into the catheter and the catheter is removed. A special brush is inserted and used to clear the blockages and to get material for cytopathologic analysis.

The last part of the video is from another patient and shows the placement of a self-expanding metallic stent in the ampulla of Vater.

Watch the ERCP video

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