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ERCP is the abbreviation of endoscopic retrograde cholangiopancreatography. Insert the duodenoscope into the descending part of the duodenum, find the duodenal papilla, insert a contrast catheter into the opening of the papilla from the biopsy duct, inject contrast medium and take X-rays to display the pancreaticobiliary duct, which is currently recognized as the gold standard for the diagnosis of pancreaticobiliary disease. In addition to diagnosis, doctors can also insert operating instruments into the duodenum along the duct of the duodenoscope to complete treatment operations such as duodenal papillalithotomy. At present, ERCP surgery is a highly professional endoscopic minimally invasive operation technology that requires high operational ability and proficiency. Compared with traditional surgical operations, it has the characteristics of relatively small trauma, fast recovery, and definite curative effect, both inspection and treatment functions.
The bile in the human body is produced in the liver cells, and the pancreatic juice is produced in the pancreas. Both of these two body fluids have the function of digesting food and promoting nutrient absorption. Therefore, after production, they must go to the intestinal tract to play a role. Therefore, the bile duct and pancreatic duct must be connected to the intestine. The bile produced by each liver cell is collected in the intrahepatic bile duct, and finally discharged from the liver into the common hepatic duct. At this time, the bile will first enter the gallbladder through the cystic duct for storage. When it needs to play a role, bile will pass through the cystic duct, enter the common bile duct, and then join the pancreatic duct to open into the duodenum. The place where the opening is called the duodenal papilla is controlled by a circle of muscles around the opening. The "flow velocity" is called the sphincter.
In this way, it is actually easy to understand. ERCP is actually inserting a duodenoscope similar to a gastroscope from the mouth to the middle of the duodenum. This is the exit of the common bile duct, which can be reversed. Contrast medium is injected into the ducts mentioned above to observe whether there are lesions, and special thin guide wires and professional endoscope accessories and supplies can also be inserted from here to perform surgical operations related to the hepatobiliary and pancreatic ducts.
As mentioned above, ERCP is not limited to the diagnosis of diseases at present, and some surgical operations can be completed in ERCP equipment to achieve therapeutic effects.
(1) Diagnosis
ERCP instruments can be used for the diagnosis of duodenal papilla, intrahepatic and extrahepatic bile ducts, pancreas and other diseases. Such as stones in various parts of the biliary tract, biliary ascariasis, extrahepatic cholangiocarcinoma, ampullary carcinoma, chronic pancreatitis, pancreatic cyst, pancreatic cancer, etc.
(2) Treatment
Duodenal papillary sphinctertome, common bile duct stone removal, endoscopic nasobiliary drainage, and endoscopic bile internal drainage can be performed. All of the above treatments are based on ERCP surgery, and at the same time as the diagnosis, the treatment of gallstone disease, acute suppurative cholangitis, acute pancreatitis, pancreatic duct stones, chronic pancreatitis, bile duct cancer, pancreatic cancer, and ampullary cancer Jaundice and other biliary and pancreatic diseases can solve the pain of patients, and it has no incision, less trauma, and is easy to be accepted by patients.
Whether it is painful to do ERCP is different for everyone. If it is painful to do gastroscopy, it should be painful to do ERCP, because their principles are similar. But in fact, clinically, for patients without contraindications, for some patients with poor tolerance, it is now possible to use general anesthesia without intubation. The patient is anesthetized first, and then undergoes ERCP surgery, which is similar to painless gastroscopy. In this way, the patient does not feel uncomfortable and will not feel uncomfortable, but the cost will increase due to the need for anesthesia.