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ERC & MRCP

Endoscopic Retrograde / Magnetic Resonance Cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure for diagnosing problems related to the gallbladder, bile ducts, and pancreas. The liver produces a fluid known as bile, which aids digestion. Bile is stored in the gallbladder until it is needed for digestion. From the liver, bile flows to the gallbladder and small intestine in the bile duct. The biliary tree consists of these ducts. Besides producing enzymes that are useful for digestion, the pancreas also secretes hormones such as insulin.

ERCP Diagnosis:

A lighted endoscope is inserted into the patient's mouth during a diagnostic ERCP. After passing through the oesophagus, stomach, and small intestine opening, this is then safely eliminated. In order to insert the endoscope into the pancreatic duct and the biliary duct openings at the same time, a tube will need to be inserted at the centre of the endoscope.

Throughout the tube is run a dye known as a contrast medium. Once the contrast medium is used the X-ray is taken. In addition to helping to highlight the areas of interest, the contrast medium might provide the physician with information about a blockage or another issue that may not otherwise be apparent. Video equipment is also incorporated into modern endoscopes, providing the physician with additional diagnostic options.

The ERCP is performed in order to:

  • Diagnosing and treating pancreatic or bile duct disorders (such as stones)

  • An ultrasound or CT scan helps diagnose symptoms (i.e. abdominal bloating or jaundice) or clarify abnormal results from blood work, ultrasounds, or CT scans.

  • During or after gallbladder surgery.

  • Using indwelling plastic tubes called stents, tumours can be diagnosed and blocked bile ducts can be bypassed.

  • As well as detecting and treating problems following gallbladder surgery, ERCP can detect and treat other health conditions.

Procedure:

The Endoscopic Retrograde Cholangiopancreatography (ERCP) method uses an endoscope and X-rays. This is accomplished using a flexible lighted and long tube. Your doctor uses the endoscope to visualize the biliary tree and pancreas, as well as to inject a dye into the ducts in order to visualize them on X-rays.

It is a procedure that requires you to lie down on a table. During the procedure, we will use local anaesthesia and sedation to relax you. An endoscope is guided through your oesophagus, stomach, and duodenum until it reaches the duodenum and the bile duct. X-ray equipment takes pictures after the dye is injected and the dye is injected. It will be possible to determine whether the ducts are narrowed or blocked by this method. An evaluation may be furthered by a biopsy, or even removal of a gallbladder stone or blockage can be performed. The endoscope will be removed once the procedure is completed.

MRCP

Magnetic resonance cholangiopancreatography (MRCP) is a type of magnetic resonance imaging (MRI) examination that produces detailed images of the pancreatic, biliary, and liver systems. Diagnostic tests such as magnetic resonance imaging (MRI) are non-invasive ways to discover medical conditions.

Magnetic resonance imaging (MRI) utilizes a powerful magnetic field, radiofrequency pulses, and a computer to provide detailed pictures of body structures. There is no radiation involved (x-rays are not used). An MR image provides doctors with detailed information about the body and helps them to detect disease.

What are some of the common uses of the procedure?

Magnetic Resonance Cholangiopancreatography or MRCP is used by physicians to:

  • Analyze diseases of the liver, gallbladder, bile ducts, pancreas, and pancreatic duct. This includes tumours, stones, swelling, and other infections.

  • Diagnose pancreatitis according to the underlying cause. In patients with pancreatitis, an MRCP may be performed with the use of the drug Secretin to determine whether long-term scarring has occurred and whether sufficient pancreatic function and secretions are present.

  • Diagnose abdominal pain that is not explained.

  • ERCP is a non-invasive alternative to endoscopic retrograde cholangiopancreatography (ERCP). The endoscopic retrograde cholangiopancreatography procedure combines endoscopy, which uses an illuminated optical instrument to look inside the body, with iodinated contrast injections and X-ray images to diagnose disease. A biliary and/or pancreatic duct exam is performed during an ERCP procedure.

Procedure

  • MRI exams can be performed as an outpatient procedure.

  • You will be positioned on the moveable exam table by the technologist. To keep you still and in position, straps and bolsters can be used.

  • When examining the body, the technician may use devices that contain coils capable of transmitting and receiving radio waves.

  • There may be several runs (sequences) in an MRI exam, some of which may last for several minutes. There will be different sounds associated with each run.

  • You'll need an intravenous catheter (IV line) to receive contrast material during your exam. The catheter will be inserted into a vein in your hand or arm. This IV will be used to inject the contrast material.

  • During the MRI, you will be placed in the magnet. As the exam is being performed, the technologist will be working on a computer outside of the room. An intercom will allow you to speak with the technician.

  • After an initial series of scans, the technologist will inject the contrast material into the intravenous line (IV). Following the injection, the technician will take more images.

  • MRCP takes approximately 10-15 minutes, but it is often performed in conjunction with a standard abdominal MRI, which can last an estimated 30 minutes and involves the use of contrast material. When the procedure is completed in this manner, it usually takes approximately 45 minutes.

Equipment

A traditional MRI machine consists of a large cylinder surrounded by a circular magnet. On the table, there is a tunnel through which you slide towards the magnet’s centre. Short-bore systems are some MRI units that do not fully enclose the patient with a magnet. Larger or claustrophobic patients may find newer MRI machines more comfortable because they have a larger bore diameter. Units that are open on the sides are considered “open” MRIs. Patients with claustrophobia or larger patients may find them particularly useful. High-quality images can be obtained through open MRI units for a variety of tests. Some tests may not be suitable for open MRI. 

Frequently Asked Questions

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