Endoscopic retrograde cholangiopancreatogram
- Previous stomach surgery that precludes easy passage of the endoscope into the duodenum
- Uncorrected coagulopathy (if intervention considered)
The initial insertion of the ERCP endoscope is similar to a conventional upper GI endoscopy. The important difference is that the endoscope used in ERCP is side-viewing and has additional channels to facilitate the imaging and intervention.
Once the endoscope is in the second/third part of the duodenum, the papilla of Vater is cannulated. Injection of radio-opaque contrast is observed fluoroscopically, giving images of the outlined pancreatic and biliary ducts.
Brushing may be indicated for cytological diagnosis of carcinoma with sensitivites of 30-75% for adenocarcinoma of pancreas.
- Endoscopic retrograde cholangiopancreatography in gallstone-associated acute pancreatitis, Cochrane Systematic Review (2005)
- A systematic review and economic evaluation of magnetic resonance cholangiopancreatography compared with diagnostic endoscopic retrograde cholangiopancreatography, Health Technology Assessment (2004)