By Todd H. Baron MD FASGE, Richard A. Kozarek MD FASGE, David Leslie Carr-Locke MD FRCP FACG FASGE
ERCP, now in its moment version, is devoted to simplifying and explaining every thing you have to comprehend to successfully and adequately perform endoscopic retrograde cholangiopancreatography. top quality photos, illustrative diagrams, and insurance of the newest thoughts advisor you thru this complicated subject and assist you in achieving optimum outcomes.
- Deliver the simplest therapy
- Master the most recent diagnostic and healing ideas with ERCP - your visual and interactive guide to this more and more vital procedure!
with an in-depth evaluation of complex ERCP tactics, and equip your self with the latest innovations, healing modalities, and guidelines.
- Apply the newest ERCP techniques
- Enhance your learning with assistance from summaries following each one bankruptcy, up-to-date photographs all through, and a wealth of illustrative diagrams demonstrating key information.
- See how it really is done. Over 40 videos function the newest systems, resembling Needle Knife Sphincterotomy, Biliary Sphincterotomy, Cannulation, and Fistulotomy.
- Access the totally searchable textual content, obtain all of the photographs, and watch key movies online at www.expertconsult.com!
with eleven new chapters overlaying Cholangioscopy: Videocholangioscopy; Echoendoscopic Ultrasound; Endoscopic Ultrasound; mixed Biliary and Duodenal Obstruction; and more.
Read Online or Download ERCP PDF
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Extra info for ERCP
Inadequate ﬁlling may result in overestimation of strictures, and the “shouldered” feature of malignant strictures may not be ideally demonstrated without adequate duct ﬁlling (Fig. 17). Likewise the characteristics of benign strictures are better delineated with adequate duct ﬁlling (Fig. 18). Changing the patient’s position may also help to correctly identify the source of bile leak if aberrant or overlapping ductal structures are present (Fig. 19). As in the case of injecting near a stricture to better characterize its extent and character, injecting near the site of a bile leak D Fig.
32) or stent placement (Fig. 33) so long as an image is obtained to document the event. However, in other circumstances such as in patients with sphincter of Oddi dyskinesia, both the bile and pancreatic ducts may be morphologically normal, and the diagnosis cannot be made on the basis of images alone. Communication of manometric measurements, if acquired, and clinical factors in these patients is critical to insure an accurate interpretation of the radiographs. In summary, the modern-day practice of ERCP involves a large percentage of therapeutic procedures and frequently does not permit B C Fig.
A B Fig. 24 Chronic pancreatitis. A Early ﬁlling of the main pancreatic duct shows dilation in the tail region, upstream from a smooth stricture (arrow) in the proximal body region. B With further injection and repositioning of the scope, there is better demonstration of the stricture in the body (white arrow), as well as side branch dilation and a second focal inﬂammatory stricture of the main pancreatic duct in the neck region (black arrow). A B Fig. 25 Acinarization during pancreatic duct injection.