Ercp

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This is a slide show on Endoscopic Retrograde Cholangiopancreatography

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Ercp

  1. 1. ERCP : E ndoscopic R etrograde C holangio P ancreatography Dr Abd Hamid Mat Sain
  2. 2. Flexible Gastrointestinal Endoscopies <ul><li>O esophago G astro D uodeno S copy (OGDS) </li></ul><ul><li>Colonoscopy </li></ul><ul><li>ERCP </li></ul><ul><li>(Enteroscopy) </li></ul>
  3. 4. Indications <ul><li>Obstructive Jaundice </li></ul><ul><li>Acute Pancreatitis </li></ul><ul><li>Common Bile Duct Stones (Gallstones) </li></ul><ul><li>Post Cholecystectomy Problems </li></ul><ul><li>Pancreatic lesions </li></ul>
  4. 5. Pre ERCP Investigations <ul><li>Buse, Creat </li></ul><ul><li>FBC </li></ul><ul><li>LFT </li></ul><ul><li>PT, APTT </li></ul><ul><li>Hepatitis Screen </li></ul><ul><li>Blood Group </li></ul><ul><li>US Abdomen </li></ul>
  5. 6. Pre ERCP Treatment <ul><li>NBM 8 hours </li></ul><ul><li>FFP </li></ul><ul><li>Tranexamic Acid </li></ul><ul><li>IV Antibiotics – Tazocin </li></ul><ul><li>IV Drip </li></ul><ul><li>Good Urine Output </li></ul><ul><li>ECG </li></ul><ul><li>CXR </li></ul>
  6. 7. ERCP Steps <ul><li>Patient positioning </li></ul><ul><li>Anaesthesia/Sedation </li></ul><ul><li>Scope positioning </li></ul><ul><li>Cannulation </li></ul><ul><li>Contrast </li></ul><ul><li>Cholangiography/Pancreatography </li></ul><ul><li>Papillotomy </li></ul><ul><li>Stones Extraction </li></ul><ul><li>Biopsy </li></ul>
  7. 8. Drugs during ERCP <ul><li>IV Dormicum 5mg and titrate to 15mg </li></ul><ul><li>IV Pethidine 50mg and titrate to 100mg </li></ul><ul><li>Iv Buscopan 10mg and titrate to 20mg </li></ul>
  8. 9. Stenting <ul><li>CBD stones </li></ul><ul><li>Tumour </li></ul><ul><li>Stricture </li></ul>
  9. 10. ERCP Complications <ul><li>90% Success </li></ul><ul><li>Acute Pancreatitis </li></ul><ul><li>Bleeding </li></ul><ul><li>Sepsis </li></ul><ul><li>Perforation </li></ul><ul><li>Impacted Stone </li></ul><ul><li>Impacted Basket – Soehendra Lithotriptor </li></ul>
  10. 11. Post ERCP Treatment <ul><li>Close Monitoring BP/P </li></ul><ul><li>NBM till reviewed </li></ul><ul><li>Se Amylase 1hr post ERCP </li></ul><ul><li>IV Drip </li></ul><ul><li>IV Antibiotics </li></ul><ul><li>ERCP Reports </li></ul>
  11. 24. Thank You

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