ERCP for Stone & Malignancy

ERCP is highly effective in removing stones from the bile duct (choledocholithiasis) and pancreatic duct. These stones can cause blockages, leading to pain, jaundice, and infections like cholangitis or pancreatitis.

Procedure:

• Cannulation: The endoscope is passed through the mouth, esophagus, and stomach into the duodenum, where the bile and pancreatic ducts are accessed.
• Sphincterotomy: A small incision is made in the sphincter of Oddi (the muscle controlling the flow of digestive juices) to allow easier access to the ducts.
• Stone Extraction: Stones are removed using specialized tools like baskets or balloons. In some cases, the stones are broken up using techniques like lithotripsy before removal.
• Stent Placement: If the ducts are narrowed due to scarring or stones, a stent may be placed to keep them open and ensure proper bile flow.

ERCP for Malignancy

ERCP is also used to diagnose and manage cancers of the bile ducts (cholangiocarcinoma), pancreatic cancer, and other malignancies that affect the biliary or pancreatic systems.

• Stent Placement: Malignancies can cause blockages in the bile ducts, leading to jaundice and other complications. ERCP allows for the placement of plastic or metal stents to relieve these obstructions and improve bile flow.
• Biopsy: During ERCP, tissue samples can be obtained from suspicious areas within the ducts or pancreas for histopathological examination, aiding in cancer diagnosis.
• Palliative Care: In cases where the malignancy is not resectable, ERCP is used for palliative care to manage symptoms and improve the quality of life by relieving ductal obstructions.

Benefits and Risks

• Benefits: ERCP is less invasive than open surgery and allows for both diagnosis and treatment in one procedure. It is particularly valuable for managing biliary and pancreatic ductal issues with minimal recovery time.
• Risks: The procedure carries risks, including pancreatitis, infections, bleeding, and, in rare cases, perforation of the GI tract. The risk of complications increases with the complexity of the procedure.