Endoscopische procedure V: ERCP

Endoscopic Retrograde Cholangiopancreatography, or ERCP, is a therapeutic procedure integrating endoscopy with fluoroscopy to examine and treat conditions affecting the biliary and pancreatic ductal system.

The patient preparation includes explaining the procedure, restricting oral intake for eight hours, withholding medications like NSAIDs, and obtaining informed consent.

Medications such as glucagon or anticholinergic agents are administered to facilitate cannulation by reducing duodenal peristalsis.

The ERCP procedure begins with inserting a side-viewing duodenoscope through the patient's mouth, the esophagus, and the stomach until it reaches the duodenum.

Once positioned correctly, a cannula or catheter is guided through the duodenoscope into the major duodenal papilla.

A contrast material is then injected into the ducts, and fluoroscopy captures real-time X-ray images, enabling the visualization of contrast flow and identifying abnormalities like gallstones and biliary strictures.

Post-procedure assessments include checking vital signs, the return of the gag reflex, and signs of perforation, such as abdominal pain, excess gas, and fever development.