Abstract:
Endoscopic retrograde cholangiopancreatography
(ERCP) is a specialised endoscopic procedure for
managing pancreatic and biliary diseases. Earlier
in the 1970s, ERCP was mainly used for diagnostic
purposes to evaluate the biliary and pancreatic ducts
and surrounding structures. But nowadays, as noninvasive imaging studies advance, it is primarily used
for therapeutic purposes though it is used for therapeutic
and diagnostic purposes.
Therapeutic ERCP is broadly used in conditions that lead
to impairment in bile flow and leak. The requirement of
the ERCP extended further for evaluation of pancreatitis
of unknown aetiology, preoperative evaluation of the
patient with chronic pancreatitis and evaluation of the
sphincter of Oddi by manometry.
Patients should be selected with a clear-cut indication
for ERCP, avoiding unnecessary or marginally indicated
ERCP, especially in high-risk patients. ERCP is
usually performed using a dedicated side-viewing
endoscope with the patient positioned prone on a
fluoroscopy table under sedation or general anaesthesia.
Proper positioning of the duodenoscope is the key to
cannulation of the pancreatic or common bile ducts.
