ERCP (Endoscopic Retrograde Cholangio Pancreatography) is an endoscopic procedure used to diagnose and treat issues in the bile and pancreatic ducts. It involves positioning an endoscope and using x-rays to view the ducts while performing procedures like draining bile ducts, removing gallstones, and placing stents. Potential complications include pancreatitis, bleeding, infection, or perforation. Careful pre- and post-procedure steps like monitoring and antibiotics are important to minimize risks.

1. ERCP : E ndoscopic R etrograde C holangio P ancreatography Dr Abd Hamid Mat Sain

2. Flexible Gastrointestinal Endoscopies O esophago G astro D uodeno S copy (OGDS) Colonoscopy ERCP (Enteroscopy)

4. Indications Obstructive Jaundice Acute Pancreatitis Common Bile Duct Stones (Gallstones) Post Cholecystectomy Problems Pancreatic lesions

5. Pre ERCP Investigations Buse, Creat FBC LFT PT, APTT Hepatitis Screen Blood Group US Abdomen

6. Pre ERCP Treatment NBM 8 hours FFP Tranexamic Acid IV Antibiotics – Tazocin IV Drip Good Urine Output ECG CXR

7. ERCP Steps Patient positioning Anaesthesia/Sedation Scope positioning Cannulation Contrast Cholangiography/Pancreatography Papillotomy Stones Extraction Biopsy

8. Drugs during ERCP IV Dormicum 5mg and titrate to 15mg IV Pethidine 50mg and titrate to 100mg Iv Buscopan 10mg and titrate to 20mg

9. Stenting CBD stones Tumour Stricture

10. ERCP Complications 90% Success Acute Pancreatitis Bleeding Sepsis Perforation Impacted Stone Impacted Basket – Soehendra Lithotriptor

11. Post ERCP Treatment Close Monitoring BP/P NBM till reviewed Se Amylase 1hr post ERCP IV Drip IV Antibiotics ERCP Reports

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