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ERCP surgery, also known as endoscopic retrograde cholangiopancreatography, is a procedure that involves inserting an endoscope into the descending duodenum to locate the ampulla of Vater. A catheter is then inserted through the biopsy channel into the opening of the ampulla, and contrast material is injected before X-ray imaging to visualize the pancreatic and biliary ducts.
ERCP has gained great success in clinical practice over the past few decades due to its minimally invasive nature, short operation time, fewer complications compared to other surgical procedures, and significantly reduced hospitalization time, making it popular among patients. ERCP has become an important therapeutic method for pancreatic and biliary diseases.
Jaundice caused by biliary obstruction
Pancreatic or biliary diseases supported by clinical, laboratory or imaging examinations (such as stones, tumors, sclerosing cholangitis, etc.)
Pancreatic diseases: pancreatic tumors, chronic pancreatitis, pancreatic pseudocysts, etc.
Idiopathic pancreatitis
Sphincter of Oddi manometry
Tissue biopsy of pancreatic duct or biliary duct
It should be emphasized that due to the advancements in computed tomography (CT), endoscopic ultrasound (EUS), and magnetic resonance cholangiopancreatography (MRCP), the use of ERCP for diagnostic purposes is now rarely applied unless there is a high suspicion of a specific disease or ERCP is needed to assist in diagnosis.
Severe cardiac, pulmonary, or renal dysfunction
Acute pancreatitis or acute exacerbation of chronic pancreatitis (except for biliary origin)
Allergy to iodine contrast agents
After completion of the ERCP instrument procedure, if external drainage is required, it can be removed in 4-5 days after the patient has returned to normal health. If a stent is used and there are no symptoms of bleeding or perforation, the patient needs to undergo blood, urine amylase, and blood routine tests immediately after surgery and the following morning. If there is an increase in these tests, the patient should be restricted from eating and drinking and should take medication until their blood and urine amylase levels return to normal. Generally, patients can be discharged from the hospital after about 5 days, and can perform relatively heavy labor after about 10 days.
ERCP can be used to place a nasobiliary drainage tube (ENBD) under endoscopy for the treatment of acute suppurative obstructive cholangitis, perform biliary stent drainage, cholangiolithiasis extraction, and other minimally invasive treatments. With the advancement of imaging technologies, MRCP has gradually replaced diagnostic ERCP as the preferred diagnostic method for pancreatic and biliary diseases due to the advantages of being non-invasive, free from X-ray exposure, and not requiring contrast agents. ERCP has gradually shifted towards the treatment of pancreatic and biliary diseases due to its minimally invasive nature, short operation time, fewer complications than other surgical procedures, and significantly reduced hospitalization time, making it popular among patients. It has become an important therapeutic method for pancreatic and biliary diseases today.