ERCP refers to the imaging technique of inserting a duodenoscope through the ampulla of Vater to inject a contrast agent, thereby retrogradely displaying the pancreaticobiliary duct. It is currently the gold standard for diagnosineg and treating pancreaticobiliary diseases such as common bile duct stones and obstructive jaundice. Based on ERCP, internal drainage can be used to solve the obstruction of the bile duct and pancreatic duct caused by stones and stenosis, improve the drainage function and achieve the purpose of treatment, avoiding the large-trauma surgery. It is one of the main ways to treat biliary-pancreatic diseases. Based on ERCP, procedures such as endoscopic sphincterotomy (EST), common bile duct stone removal surgery, and endoscopic stent implantation can be performed.
Unlike traditional surgical procedures, ERCP endoscopic minimally invasive surgery has the advantages of minimal trauma and fast recovery. Generally, patients only need to stay in the hospital for two to three days to complete the discharge procedures. In addition, endoscopic minimally invasive surgery also has its unique advantages for certain diseases. Let's take a look at the advantages of endoscopic minimally invasive surgery in these diseases below.
Common bile duct distal small stones
The small stones at the distal end of the common bile duct are embedded in the ampulla of Vater and have obvious clinical symptoms that are difficult to detect on CT or MRCP. However, ERCP minimally invasive surgery has significant advantages in detecting distal stones. It can detect whether the intrahepatic and extrahepatic bile ducts are dilated or not dilated. In addition, when patients undergo surgery for gallbladder stones combined with common bile duct stones, the method of laparoscopic cholecystectomy can be used to expand the indications for LC, which is more conducive to the doctor's operation during surgery.
Bile duct cancer
Compared with B-ultrasound and CT scans, endoscopic minimally invasive surgery based on ERCP has significant advantages in diagnosing early bile duct cancer. During the biopsy of bile duct tissue, doctors can use endoscopic minimally invasive surgery and intraductal ultrasonography under duodenoscopy to improve the diagnostic accuracy, and the overall view of the biliary system can also be shown clearly, thus enabling doctors to choose more favorable treatment and surgical plans.
Pancreatic divisum
Pancreatic divisum is a congenital developmental abnormality of the pancreas, which causes symptoms such as pancreatic excretion disorder and obstruction, leading to recurrent pancreatitis in patients. It can be said that the only way to diagnose pancreatic divisum is through endoscopic minimally invasive surgery because, compared with traditional examination methods, ERCP endoscopic minimally invasive surgery shows shorter length of the ventral and dorsal pancreatic ducts, which is easier for doctors to observe.
Ampullary and Vater lesions
Generally speaking, ERCP is the preferred method for diagnosing ampullary and Vater cancer. During the process, doctors perform local resection or biopsy of the Vater's ampulla, and obtain pathological confirmation by brushing cells under endoscopic visualization.
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