endoscopic retrograde cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) has the advantages of safety, simplicity, and fewer complications. ERCP has the highest diagnostic sensitivity and accuracy and has become an important means of diagnosis and treatment of biliary and pancreatic diseases. Because ERCP does not require surgery, the trauma is small, the operation time is short, the complications are less than the surgery, and the hospitalization time is greatly shortened, which is very popular among patients. Basic Information Specialist classification: Digestive examination classification: endoscope Applicable gender: whether men and women apply fasting: not fasting Tips: iodine allergy; obvious cardiopulmonary insufficiency and upper gastrointestinal endoscopy are contraindicated; acute cholangitis, acute pancreatitis is not suitable for this examination. Normal value The gallbladder and pancreatic duct are filled and developed. Clinical significance Abnormal results: There are stones in the gallbladder, gallbladder tumors, and inflammation of the pancreas. Need to check the crowd: 1. Obstructive jaundice, benign, malignant lesions and bile duct stricture. 2. Biliary stones, especially extrahepatic bile duct stones, aphids and the like. 3. Bile duct injury and bile leakage after gallbladder or bile duct surgery. 4. Symptoms of recurrence after gallbladder and bile duct surgery, unexplained biliary colic. 5. Pancreatic stones, chronic pancreatitis. 6. PTC failed or contraindicated. Precautions Taboo before inspection: None. Taboo when checking: 1. Inject the contrast agent, only the pancreatic duct is developed and the pancreatic duct is displayed. The contrast agent can be injected slowly, at low pressure and in a small amount. Otherwise, the pancreatic duct hypertension is easy to be complicated with pancreatitis. If the bile duct is the main display, the catheter position should be adjusted, and a small amount of contrast medium can be injected into the bile duct to inject a sufficient amount of contrast agent. 2. Proper use of antibiotics to prevent bile duct infection. 3. Close observation after angiography for 24 hours, if complications occur, should be treated in time. Inspection process 1. According to the procedure of fiber duodenal microscopy, the endoscope is placed in the descending segment of the duodenum to find the nipple opening. 2. Insert the contrast catheter, the general rule is that the catheter and the nipple opening are slightly perpendicular to the left and easy to insert into the pancreatic duct. The catheter is slightly up to the right and easy to enter the bile duct. The depth of the cannula is preferably 0.5 cm, and the deep catheter is easy to enter a single tube of the gallbladder or pancreas. Try a small amount of contrast agent (60% diatrizoate). Double tube development is most satisfactory. Then, an appropriate amount of contrast agent is slowly injected, and the gallbladder and pancreatic duct are filled to develop a satisfactory posterior film. After removing the endoscope and contrast tube, adjust the position as needed to repeat the film and understand the emptying. Not suitable for the crowd Unsuitable for people: iodine allergy; obvious cardiopulmonary insufficiency and upper gastrointestinal endoscopy for contraindications; acute cholangitis, acute pancreatitis.

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