Endoscopic retrograde cholangiopancreatography (ERCP) is a sophisticated endoscopic study whose purpose is to evaluate the papilla of Vater (outlet of bile and pancreatic juices to the intestine), the bile duct, and the pancreatic duct.

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What does the study consist of?

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The procedure is performed with a device called a duodenoscopio whose main characteristic is that it is lateral vision instead of being frontal vision like all other endoscopes. It is performed in an X-ray room that has high-resolution fluoroscopy.

Under assisted sedation, the duodenoscope is inserted through the mouth, passed through the stomach and duodenum where the papilla of Vater is located. This structure has two small holes through which a thin cannula is passed, through which contrast medium is injected, which allows radiological visualization of the bile duct and pancreatic duct, detecting diseases very precisely.

The study does not only specify the diagnosis. By detecting the problem, multiple treatments can be performed in the same procedure, thus avoiding surgical interventions. It is possible to make a small cut in the exit hole (sphincterotomy), which allows us to extract stones (lithos), install plastic drainage prostheses or expandable metal prostheses. You can do dilations in areas of narrowing, take biopsies and cytology.

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What treatment methods can be performed?

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Benign tumors of the papilla of Vater called adenomas can be removed, sphintrotomy of the bile duct, pancreatic or both can be performed in the case of stenosis at this level or hypertonic sphincters. It is possible to extract stones from the two ducts and manage benign and malignant strictures with the installation of prostheses and dilations.

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What are the complications?

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The most common complication is post-procedure pancreatitis, which is generally mild to moderate, although it can be severe on rare occasions. The possibility of infection, perforation or bleeding is unlikely. All these complications require hospitalization, sometimes transfusions and rarely surgery.