By Peter B. Cotton
Advanced Digestive Endoscopy: ERCP addresses the most complicated diagnostic and healing methods for endoscopists. It presents the newest considering and transparent guideline at the suggestions, that have been built-in with total sufferer care.
Written through the major foreign names in endoscopy, the textual content has been expertly edited by means of Peter Cotton right into a succinct, instructive structure. offered in brief paragraphs based with headings, subheadings and bullet issues and richly illustrated all through with full-color images.
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Additional resources for Advanced Digestive Endoscopy: ERCP
Prior insertion of a stent into the pancreatic duct protects the pancreatic oriﬁce and may minimize the risk of pancreatitis. Precut needle-knife sphincterotomy over a stent is also used to perform accessory sphincterotomy for pancreas divisum. Selective cannulation of the intrahepatic system (IHBD) In a standard short scope position, the angulation of the scope, curvature of the cannula, and shape of the CBD all favor cannulation of the right hepatic system. Selective cannulation of the right hepatic system is facilitated by the use of a Jtipped guidewire or a straight guidewire contained in a curved catheter, although a curved cannula may sometimes lodge in the cystic duct.
Straight catheter from a distance to obtain correct axis. In difﬁcult cases, intubation of the gastroenterostomy is performed by backing the scope into the correct loop. Sometimes biopsy forceps may help the passage or advancement of the scope into the afferent loop. Passage of the scope down the small intestine is similar to doing a colonoscopy with a side-viewing endoscope. The presence of bile in the lumen does not always predict the afferent loop. It is helpful to monitor the passage of the endoscope on ﬂuoroscopy to determine the direction and position of the scope.
Anticoagulation therapy is restarted after the procedure. Antibiotics may be given to patients with coexisting cholangitis and those with signiﬁcant biliary stasis. 2 mm channel endoscope for therapeutic procedures because it can accept larger accessories. g. Billroth II). In general, the sphincterotome is a single, double or triple lumen Teﬂon catheter containing a continuous wire loop with 2–3 cm of exposed wire close to the tip. The other end of the wire is insulated and connected via an adaptor to the diathermy or electrosurgical unit.
Advanced Digestive Endoscopy: ERCP by Peter B. Cotton