Šta je ERCP ?
Endoskopska retrogradna holangiopankreatografija (ERCP) je postupak koji kombinira endoskopiju gornjeg gastrointestinalnog (GI) i rendgenske snimke za liječenje problema žučnih i pankreasnih kanala.
Kada se radi ERCP ?
Ljekari izvode ERCP kada su vam žučni kanali ili kanali gušterače postali suženi ili začepljeni zbog:
- Žučnih kamenaca (formiraju u žučnom mjehuru) u zajedničkom žučnom vodu,
- infekcija,
- akutni i hronični pankreatitis
- traume ili hirurške komplikacije u vašim žučnim ili pankreasnim kanalima
- pseudociste gušterače
- tumori ili karcinomi žučnih vodova
- tumori ili karcinomi gušterače
ERCP se prvenstveno koristi za dijagnozu i liječenje stanja žučnih kanala i glavnog kanala pankreasa. ERCP se može izvoditi iz dijagnostičkih i terapijskih razloga, iako je razvoj sigurnijih i relativno neinvazivnih istraživanja kao što je magnetna rezonanca holangiopankreatografija (MRCP) i endoskopski ultrazvuk značilo da ERCP sada rijetko radi bez terapijske namjere.
Kako se izvodi ERCP?
Intravenska (IV) igla će vam biti stavljena u ruku kako biste dobili sedativ. Sedativ će se ubrizgati, te ćete gotovo odmah osjetiti opuštenost i pospanost. Dok ste u sedaciji, provodi se trajno praćenje vaših vitalnih funkcija, (količina kisika u krvi te vrijednosti krvnog tlaka i pulsa). Od vas će se tražiti da legnete na stol za pregled. Ljekar će pažljivo uvesti duodenoskop niz vaš jednjak, kroz želudac i u dvanaesnik. Mala kamera postavljena na duodenoskop šalje video sliku na monitor. Duodenoskop pumpa zrak u vaš želudac i dvanaesnik, čineći ih lakšim za uočavanje. Tokom ERCP-a, ljekar:
- locira otvor gdje se žučni i kanali gušterače ispuštaju u duodenum,
- provlači tanku, fleksibilnu cijev zvanu kateter kroz duodenoskop u kanale
- ubrizgava posebnu boju, također zvanu kontrastno sredstvo, kako bi kanali bili vidljiviji na rendgenskim zrakama
- koristi vrstu rendgenskog snimanja, nazvanu fluoroskopija, za pregled kanala i traženje suženih područja ili blokada
Ljekar može provući sitne alate kroz duodenoskop kako bi
- otvorio začepljene ili sužene kanale.
- razbio ili uklonio kamenje
- obavio biopsiju ili uklonio tumore u kanalima.
- umetnuo stentove—sićušne cjevčice koje ljekar ostavlja u suženim kanalima kako bi ih držao otvorenim.
Postupak najčešće traje između 1 i 2 sata.
Prvi u regionu radimo insuflaciju sa CO2
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