Ercp

Ercp

What is ERCP?

Ercp is a word created from the initials Endoscopic Retrograde Cholangio Pancreotography. An image of the biliary tract is obtained by going to the area where the biliary tract flows endoscopically, placing a catheter at the biliary tract outlet and injecting a liquid contrast material that can be seen on the x-ray. Thus, it is understood whether there are stones in the biliary tract and whether there is pressure from any tumor.

Which Treatments Can Be Performed With ERCP?

  • ERCP can clear the stones which cause the occlusion in the bile duct.
  • The exit part of the choledochus can be opened by cutting the adenoma of the Vater ampoule, which can cause occlusion.
  • During the preparation of the operation, temporary catheters of Nazo-biliary drainage may put to reduce the risk of the operation by reducing the levels of high bilirubins at the mass in the head of the pancreas which can cause occlusion.
  • Permanent stents can put to provide the gall flowing in the advanced bile-pancreatic duct that may be another cause of the occlusion and non-operable.

What are the causes of the biliary obstruction?

  • Gallstones in the choledoch
  • Tumors of ampulla of vater
  • Mass in the head of the pancreas
  • Chronic pancreatitis
  • of Biliary tract neoplasms
  • Binding the common bile duct accidentally during the cholecystotomy
  • Mirizzi’s syndrome > occurs as a result of the acute inflammation of gall enters the bile ducts

Why is ERCP Performed?

In previous years, ERCP was carried out only for the purpose of diagnosing pathologies in the bile ducts but has now taken MRCP or endoscopic ultrasound examinations for this. ERCP is now only available for the purpose of treatment.

The most common use of ERCP is the obstructive jaundice problems made by stones in the bile ducts to the present day. Stones in the bile ducts usually form by falling from the gall bladder to this path. However, especially in people whose gallbladder has been removed before, new stones may form again over time from the bile ducts themselves.

When the stone falls into the bile ducts, the stone leads to the outlet of the bile ducts. And it wants to go from here to the small bowel. Normally, when the bile ducts close the place where the small bowel flows into, it merges with the main canal from within the pancreatic gland. As if the two rivers were flowing out of one mouth, they flow into the small bowel.

Therefore, when a stone falling into the biliary tract comes to the exit and cannot pass the narrow exit here, it blocks both the biliary tract and the pancreatic duct.

Anatomy of the bile duct

The place where the bile ducts open to the small bowel is defined as the papilla. When we look at from the small bowel, the papilla is looked like as the nipple. A very little imperceptible tedge may be seen in the middle of it. There is a space that defined as the ampulla of Vater where the bile duct and the pancreatic duct merge in the inner of this tedge. Stones can occlude both ducts by settling in this area.

papilla
Ercp nedir

The papilla is the point that the bile duct and the pancreatic duct merge and flow into the small bowel.

The name  of the common bile duct is the common bile duct or it can be called the common bile duct. Bilirubin which is a material in the gall cannot pass the little bile ducts in the liver, because when choledochal is occluded by stones, it cannot clear the gall which needs to reach to the small bowel by passing through it. These materials which cannot be thrown to the bile ducts start to pass into the blood. 

High level of bilirubin in the blood causes yellowing of the whole body, especially skin and eye. It is defined as obstructive jaundice.

So ERCP not only provides the enlargement by cutting the low end of the bile ducts with a device named as papillotomy especially in the case of occlusion such as stone but also clears these foreign matters from the bile duct with a catheter-like a balloon or a basket. Below, these procedures are showed and explained with the purpose of the information in ERCP that I applied.

Contracted Institutions

Private Insurances

  • Acıbadem Sigorta
  • Axa Sigorta
  • Mapfre Sigorta
  • Allianz Sigorta

Click to see all the private insurances we have agreements with.

Public Organizations

  • SGK
  • ES pension
  • PTT
  • TBMM

Click to see all the public institutions we have agreements with.

ERCP Transaction Prices

  • The price of the ERCP procedure varies between 10,000 TL and 40,000 TL today, depending on the type of transaction performed during the procedure and the type  of materials used. Most transactions can be settled with fees close to the lower limit. However, prices may increase if you have to use a stent attachment stone crusher and if the stent used is plastic or metallic. Metal-coated stents are usually required in cases of non-stone stenosis or biliary tract or pancreatic head cancers.

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