Advanced Endoscopic Procedures in Hospital

ERCP

The term endoscopic retrograde cholangiopancreatography (ERCP) may be a mouthful for the average layperson, but it refers to procedures that enable a gastroenterologist to diagnose problems in the liver, gallbladder, bile ducts, and pancreas, such as inflammatory strictures (scars), leaks from trauma or surgery, and cancer.

The liver is a large organ that, among other things, makes bile, a liquid that helps with digestion, while the gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine, and the pancreas is a large gland that produces chemicals that help with digestion and hormones such as insulin.

ERCP combines the use of X-rays and an endoscope, which is a long, flexible, lighted tube that enables the physician to see the inside of the stomach and duodenum (the first part of the small intestine) and inject dyes into the bile ducts and pancreas, so they can be seen on X-rays.

During the procedure, you lie on your left side on a special X-ray table. You will be given medication to help numb the back of your throat and IV sedation to help you relax during the exam. The doctor inserts the endoscope through your mouth and guides it through your esophagus, stomach, and duodenum until it reaches the spot where the bile ducts and pancreas open into the duodenum.

Next, you are turned to lie flat on your stomach and the physician passes a small plastic tube through the scope to inject a dye into the ducts so they show up clearly on the X-rays. If the exam shows a gallstone or narrowing of the ducts, the doctor can then insert instruments into the scope to remove or relieve the obstruction. Also, tissue samples (a biopsy) can be taken for further testing.

An ERCP can take anywhere from 30 minutes to two hours. You will need to stay at the hospital for one to two hours while the sedative wears off and to ensure you do not experience any complications. If any treatment is performed during ERCP, such as the removal of a gallstone, you may need to stay in the hospital overnight.

Endoscopic Ultrasound

Another advanced endoscopic procedure performed in the hospital is Endoscopic Ultrasound (EUS). This combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs.

Endoscopy involves the insertion of a long flexible tube (endoscope) in the mouth or the rectum to visualize the digestive tract, while ultrasound uses high-frequency sound waves to produce images of the organs and structures inside the body such as ovaries, uterus, liver, gallbladder, pancreas, aorta, and others.

Your doctor may perform EUS to evaluate abdominal pain or abnormal weight loss that may be associated with gastrointestinal cancers, such as esophageal, stomach, pancreatic, and rectal cancer, as well as benign tumors of the upper GI tract.

With EUS, a small ultrasound transducer is installed on the tip of the endoscope. By inserting the endoscope into the upper or the lower digestive tract, your physician can obtain high-quality ultrasound images of the organs inside your body. Because of the proximity of the EUS transducer to the organ(s) being examined, the images obtained are often more accurate and detailed than the ones obtained through traditional ultrasound.

Learn more about ERCP

To learn more about the advanced endoscopic procedures our GI doctors perform, schedule a consultation with a North Shore Gastroenterology provider by calling (440) 808-1212 or by using our convenient online appointment request form. We have offices in Westlake and Brooklyn, Ohio.