Endoscopic
Ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography
(ERCP)
| |
Endoscopic Ultrasound
(EUS) |
Endoscopic Retrograde Cholangiopancreatography
(ERCP) |
| What is it? |
An endoscope is
a thin, flexible tube, which allows a doctor to examine the
gastrointestinal tract. The ultrasound component of the endoscope
uses sound waves to create visual images of the digestive
tract.
|
An
endoscope is passed through the mouth, esophagus and stomach
and into the duodenum. A narrow plastic tube, called a catheter,
is passed from the endoscope into the pancreatic and/or biliary
ducts. Dye is injected through this catheter into the ducts,
and then x-rays are taken. The images allow the doctor to
see if the pancreatic or biliary ducts are blocked due to
a tumor. |
| Reasons for procedure |
The
images created from an EUS procedure are detailed pictures
of the digestive tract. The doctor can use these pictures
to determine the size and location of tumor in the pancreas,
and whether the tumor has spread to nearby blood vessels or
other structures. In addition, the doctor can obtain tissue
samples during an EUS procedure, which will help in deciding
the best course of treatment. |
ERCP can provide
important diagnostic information to the doctor. ERCP can help
the doctor determine the cause of jaundice (yellowing of skin
and eyes), whether surgery is necessary, or help the surgeon
plan for surgery. |
| Preparation
for Procedure |
The
healthcare team will give the patient exact instructions before
an EUS or ERCP procedure. In general, the patient will not
be allowed to eat or drink anything six hours before
the examination. The doctor will tell the patient whether
he/she should continue taking medications before the EUS or
ERCP procedure. |
| Procedure |
The
patient may receive sedative medication through a vein in
the arm and local anesthetic spray to the throat, in order
to be comfortable during the procedure. The patient may feel
drowsy, but will be awake during the procedure. In addition,
some patients receive antibiotics before the procedure to
prevent infection. For the procedure, the patient lies on
his/her side and the doctor passes the endoscope through the
mouth, esophagus, and stomach and into the duodenum. The tube
will not affect the patient's ability to breathe normally.
|
| Procedure |
During an EUS, the ultrasound transducer
at the end of the endoscope uses sound waves to create images
of the pancreas and surrounding structures.
The EUS procedure usually lasts 15 to 45 minutes and is considered
by most patients to be only slightly uncomfortable. |
During an ERCP,
a small tube known as a cannula is passed from the endoscope
into the pancreatic or biliary ducts. Contrast dye is injected
into the ducts and x-rays are taken. The x-ray images are
pictures of the dye outlining the ducts, so that widening,
narrowing, or blockage of the ducts can be seen. |
| After the EUS or ERCP Procedure |
After the EUS or ERCP
procedure is completed, the patient will remain in the recovery
room until the sedative medication has worn off. The patient
should not drive a vehicle after receiving sedative medication,
and should therefore, arrange for a ride home after the procedure.
The medical care team will give the patient instructions for
taking fluids and eating meals, but usually, this will be
within a few hours after the procedure.
It is not unusual for the patient to experience a feeling of
fullness or the need to pass gas after the procedure. Also,
the patient may have changes in bowel habits, for instance,
soft stool, after the procedure. |
Possible
Complications of EUS or ERCP |
Rarely, there are complications that occur during
or after an EUS or ERCP procedure. Complications may include
inflammation or infection of the pancreas (pancreatitis), bowel
perforation (tearing), bleeding, sore throat for a day or more
after the procedure, reaction to sedative medication, or other
infection. |
