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ERCP
- 4th Edition - March 28, 2024
- Editors: Todd H. Baron, David L Carr-Locke, Richard A. Kozarek, Nageshwar Reddy
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 9 3 3 6 2 - 9
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 9 3 3 8 5 - 8
Recent years have brought major shifts in the way endoscopic retrograde cholangiopancreatography is used in everyday practice, including the incorporation of endoscopic ultrasound… Read more
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Request a sales quoteRecent years have brought major shifts in the way endoscopic retrograde cholangiopancreatography is used in everyday practice, including the incorporation of endoscopic ultrasound (EUS) techniques with ERCP. The 4th Edition of this practical reference helps you make the most of today’s ERCP in your practice, with authoritative, highly illustrated guidance on every aspect of this complex tool, including coverage of the latest techniques both in print and on video.
- Provides detailed, full-color illustrations and in-depth instructions for performing all procedures.
- Depicts each procedure in dozens of step-by-step videos that clearly show ERCP techniques and imaging interpretation, including many new or recently improved procedures.
- Covers recent advancements in balloon assisted endoscopy, and provides guidance on performing ERCP on patients with surgically altered anatomy.
- Includes new chapters on endoscopic disinfection to address antibiotic resistant bacterial infections traced back to duodenoscopes; the environmental implications of ERCP; and magnetic biliary anastomosis.
- Contains clear therapeutic guidelines that help you determine when and when not to perform ERCP.
- An eBook version is included with purchase. The eBook allows you to access all of the text, figures, and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud.
GI fellows, practitioners
- Cover image
- Title page
- Table of Contents
- Copyright
- Contributors
- Preface
- Acknowledgments
- Video contents
- List of Illustrations
- List of Tables
- SECTION 1. General Topics
- 1. ERCP—50 years and beyond
- Pancreaticobiliary anatomy and imaging: ERCP in its infancy
- The second decade
- The third decade
- ERCP in the new millennium
- ERCP: 50 years and beyond
- Acknowledgments
- Key points
- References
- 2. The ERCP room
- Evolution of the ERCP room
- Staffing for the ERCP procedure
- Room layout
- Radiologic imaging equipment
- Room integration systems
- Endoscopist work area
- Preprocedure and postprocedure work area
- Anesthesia/sedation work area
- Nursing and technician work area
- Ergonomics
- Miscellaneous issues
- Acknowledgment
- References
- 3. Radiologic issues and radiation safety in ERCP
- Introduction
- Possible reasons for inconsistent radiation safety in ERCP practice
- How a fluoroscopy machine works
- Measurement of ERCP radiation dose
- Workplace radiation safety standards
- Radiation biology and adverse effects of excess radiation exposure
- Special populations: Pregnant patients, pediatric patients, and obese patients
- Radiation safety in ERCP
- Conclusion
- References
- 4. Endoscopes, guidewires, and accessories
- Endoscopes
- Single-use duodenoscopes and duodenoscopes with disposable endcaps
- Accessories
- Accessories
- Probe-based confocal laser endomicroscopy
- Radiofrequency ablation catheter
- Other accessories
- Radiographic contrast media used in ERCP
- Role of the U.S. food and drug administration in device evaluation and monitoring
- Radiation exposure
- Conclusions
- References
- 5. Duodenoscope reprocessing
- Background
- History of mdros in endoscopy
- High-level disinfection and reprocessing
- Reaction from regulatory bodies
- Strategies for risk reduction
- Novel duodenoscope designs
- Disposable duodenoscopes
- Financial and other considerations
- Conclusions
- References
- 6. Environmental implications of ERCP/green endoscopy
- Environmental impact of endoscopy
- General departmental measures
- Single-use instruments
- ERCP accessories
- Personal footprint
- Circular healthcare economy
- Interaction with industry
- Final remarks/conclusions
- References
- 7. Sedation in ERCP
- Defining the continuum of sedation
- Sedation considerations for ERCP
- Defining sedation-related adverse events
- Risk assessment
- Anesthesia-administered sedation
- Endoscopist-directed sedation
- Monitoring
- Room setup and considerations for safety
- Conclusions
- References
- 8. Indications for and contraindications to ERCP
- Indications for and contraindications to ERCP
- Indications for ERCP
- Special cases
- Contraindications to ERCP
- Acknowledgment
- References
- 9. Adverse events of ERCP: Prediction, prevention, and management
- Introduction
- Adverse events definition
- Rates of ERCP-related adverse events
- ERCP-related risk factors
- Post-ERCP pancreatitis
- ERCP-related cholangitis and cholecystitis
- Duodenoscope-transmitted infections
- Sphincterotomy-related bleeding
- ERCP-related perforation
- Sedation-related adverse events
- Conclusion
- References
- 10. ERCP training
- Introduction
- Training in ERCP
- Current status of ERCP training
- Learning curves and competency in ERCP
- Towards competency-based medical education and validated assessment tools
- ERCP simulation
- Maintenance of ERCP skills and ERCP volume
- Quality measures for trainees and interventional endoscopy fellowships
- Future directions
- Conclusions
- References
- 11. Preparation of the patient for ERCP
- Should this patient undergo ERCP?
- When, where, and with whom?
- Evaluation of the patient before ERCP
- Preparing the patient: Day(s) before ERCP
- Method of sedation, proper personnel, and patient monitoring
- Preparing the endoscopy team
- Preparing the patient: The day of the ERCP
- References
- 12. Principles of electrosurgery
- Electrosurgery
- A brief history of electrosurgery and ERCP
- Basics of electricity as applied to electrosurgery
- Clinical applications of electrosurgery in ERCP
- References
- 13. Quality issues and measures in ERCP
- Preprocedure quality indicators
- Intraprocedure quality indicators
- Postprocedure quality indicators
- Initiating quality measurements
- Conclusions
- References
- 14. Medicolegal issues in ERCP
- How often are gastroenterologists sued?
- How common are lawsuits involving ERCP?
- What are the key legal principles?
- Standards of care and guidelines
- Who may be liable? Not only the ERCPist
- Informed consent
- Why do ERCP lawsuits occur?
- Poor endoscopic technique
- How to minimize the risk of litigation
- Managing adverse events
- When you are sued
- Expert testimony
- A summary of recommendations
- Acknowledgments
- References
- SECTION 2. Techniques
- 15. Cannulation of the major papilla and access sphincterotomy
- Establishing the duodenal position
- Devices and equipment (see also Chapter 4)
- Cannulation technique
- Wire or contrast?
- Papilla assessment and basic technique
- Small papilla
- Periampullary diverticulum
- Difficult cannulation
- Repeated cannulation of the pancreatic duct without biliary access
- Needle-knife sphincterotomy
- NKS technique
- Cannulation of the pancreatic duct
- Quality and enhancing outcomes (see also Chapters 10 and 13)
- References
- 16. Biliary sphincterotomy
- Introduction
- Description of the technique
- Contraindications
- Complications and their management
- References
- 17. Balloon dilation of the native and postsphincterotomy papilla
- Introduction
- Indications
- Techniques of balloon dilation
- Complications after EPBD and EPLBD
- Special situations
- Summary
- References
- 18. Stone extraction
- Introduction and scientific basis
- Biliary stone disease and contraindications to ERCP (see Chapter 8)
- Descriptions of techniques
- Adverse events and their management (see Chapter 9)
- Relative cost
- Conclusions
- References
- 19. Pancreatic sphincterotomy
- Endoscopic pancreatic sphincterotomy
- Indications for pancreatic sphincterotomy
- Adverse events of pancreatic sphincterotomy
- The cost of pancreatic sphincterotomy
- References
- 20. Minor papilla cannulation and sphincterotomy
- Introduction
- Indications for minor papilla cannulation and sphincterotomy
- Sedation, supplemental drugs, and ERCP accessories
- Recognition of the minor papilla
- Minor papilla cannulation
- Cannulating the minor papilla in difficult cases
- Minor papilla sphincterotomy
- Pull-type sphincterotomy or needle-knife sphincterotomy over a stent: Pros and cons
- Balloon sphincteroplasty
- Postprocedural stenting of the minor papilla
- Repeat minor papilla sphincterotomy
- Outcomes of minor papilla sphincterotomy
- Adverse events
- References
- 21. Plastic pancreaticobiliary stents and nasopancreaticobiliary tubes: Concepts and insertion techniques
- Stent systems
- References
- 22. Biliary metal stent insertion: Indications and insertion techniques
- Indications
- Description of technique
- Adverse events and their management
- Relative cost
- References
- 23. Pancreaticobiliary stent retrieval
- Removal of biliary stents
- Removal of pancreatic stents
- Lumen-apposing metal stents for gallbladder and biliary drainage
- Summary
- References
- 24. Papillectomy/ampullectomy
- Treatment options
- Considerations in FAP
- Technique (Box 24.1)
- Indications and contraindications (Box 24.2)
- Adverse events and their management (Boxes 24.3 and 24.4)
- Success
- Relative cost savings
- Subepithelial lesions
- Summary
- References
- 25. Pancreatoscopy
- History
- Equipment and technique
- Diagnostic indications
- Therapeutic indications
- Miscellaneous therapeutic indications
- Adverse events and management
- Relative cost
- Conclusions
- References
- 26. Cholangioscopy
- Digital cholangioscopy
- Videocholangioscopy using the mother–baby system
- Videocholangioscopy by the direct insertion system
- Acknowledgment
- References
- 27. ERCP and EUS in children
- Description of technique
- Indications and contraindications (Box 27.1)
- Adverse events
- Relative costs
- Endoscopic ultrasound (Box 27.2)
- References
- 28. ERCP in pregnancy
- Introduction
- Indication
- Diagnostic imaging modalities
- Timing
- Radiation exposure during ERCP
- Strategies to minimize radiation risk to the fetus
- Positioning, sedation, and medications
- Techniques
- Outcomes after ERCP during pregnancy
- Conclusion
- References
- 29. ERCP in surgically altered anatomy
- Surgery that may affect endoscope selection, scope passage, and the performance of ERCP
- Esophageal resection
- Gastric resection
- Upper GI bypass surgery without resection
- Bariatric surgery
- Pancreatic resection
- Pancreatic duct drainage procedures
- Biliary surgery
- Endoscopic techniques commonly employed for ERCP in surgically altered anatomy
- Alternative options to evaluate and treat pancreaticobiliary diseases in patients with an altered anatomy when peroral ERCP attempts have failed or such service is not available
- ERCP accessories
- Conclusion
- References
- 30. Magnetic biliary anastomosis
- History of compression anastomosis
- Indication for MCA
- Methods
- Clinical applications of MCA
- Practical tips for difficult cases
- Clinical outcomes of MCA
- Summary
- References
- 31. Endoscopic ultrasonography–guided biliary drainage
- Description of technique
- Indications and contraindications
- Procedural outcomes and adverse events
- References
- 32. Endoscopic ultrasound and EUS-guided endotherapy
- Overview
- Endoscopic ultrasonography
- Celiac nerve block and neurolysis
- Technique
- Efficacy
- Adverse events
- Drainage of pancreatic fluid collections
- Technique
- Efficacy
- Adverse events
- Pancreatic duct access and drainage
- Technique
- Biliary drainage
- Technique
- Adverse events
- Gallbladder drainage
- Technique
- Efficacy
- Adverse events
- EUS-guided ablation and cancer therapy
- Conclusions
- References
- SECTION 3. Approach to Clinical Problems
- 33. Pancreaticobiliary disorders: What are the roles of CT, MRCP, and EUS relative to ERCP?
- Role of noninvasive imaging and EUS compared with ERCP in benign hepatobiliary diseases
- Suspected pancreaticobiliary malignancy
- Conclusions
- References
- 34. Pancreas divisum, biliary cysts, and other congenital anomalies
- Ampullary anomalies
- Biliary anomalies
- Pancreatic anomalies
- References
- 35. Dilated bile duct and pneumobilia
- Dilated bile duct
- Pneumobilia
- References
- 36. The dilated pancreatic duct
- Background
- Defining dilated pancreatic duct
- Etiology
- Evaluation
- Treatment
- Conclusions
- References
- 37. Ampullary neoplasia
- Symptoms and signs
- Diagnostic workup and evaluation
- Pathology
- Treatment
- Conclusions
- References
- 38. Malignant biliary obstruction: Distal
- Epidemiology
- Natural history
- Clinical features and initial evaluation
- Differential diagnosis of distal biliary malignancies and imaging techniques
- An approach to the management of patients with distal biliary malignancies
- Summary
- Acknowledgments
- References
- 39. Malignant biliary obstruction of the hilum and proximal bile ducts
- Introduction
- Cholangiocarcinoma
- Anatomy of the bile ducts
- Diagnostic evaluation
- Management
- Conclusions
- Acknowledgments
- References
- 40. Indeterminate biliary strictures
- Introduction
- Indeterminate biliary stricture (IDBS): Establishing a diagnosis
- Endoscopic evaluation
- Peroral cholangioscopy
- Rapid-onsite evaluation touch imprint cytology
- References
- 41. Endoscopic approaches to concomitant malignant biliary obstruction and gastric outlet obstruction
- Concomitant GOO and MBO
- Anatomic and clinical scenarios
- Covered versus uncovered SEMS for GOO
- Results
- EUS-guided gastroenterostomy
- Conclusions (Figures 41.14A and B)
- References
- 42. Benign biliary strictures
- Disclosures
- Introduction
- Endoscopic classifications
- ERCP techniques for the management of BBS
- Endoscopic approach in specific etiologies
- Conclusions
- References
- 43. Biliary surgery adverse events, including liver transplantation
- Laparoscopic cholecystectomy
- Liver resection
- Liver transplantation
- Living-related-donor transplants
- Summary
- References
- 44. ERCP and EUS for acute and chronic adverse eve nts of pancreatic surgery and pancreatic trauma
- Types of pancreatic surgery
- Summary
- References
- 45. Choledocholithiasis
- Disclosures
- Introduction
- Evaluation of patients with suspected choledocholithiasis
- Extraction of bile duct stones (see Chapter 16)
- Difficult bile duct stones
- Conclusions
- References
- 46. Pancreaticobiliary pain and suspected sphincter of oddi dysfunction
- Definitions
- Clinical evaluation in patients with suspected SOD
- Upper abdominal pain with gallbladder in situ
- Informed consent for ERCP for suspected SOD
- Sphincter of Oddi manometry: Equipment and technique
- Treatment of SOD
- Endoscopic
- Prevention of post-ERCP pancreatitis
- Evaluation of patients with recurrent pain after endoscopic intervention for sphincter of Oddi dysfunction
- Conclusions
- References
- 47. Sclerosing cholangitis
- Background
- Diagnosis and natural history
- Endoscopic treatment
- Cholangiocarcinoma
- References
- 48. Tropical parasitic infestations
- Ascaris lumbricoides
- Echinococcus granulosus
- Clonorchis sinensis
- Fasciola hepatica
- Summary
- References
- 49. Recurrent pyogenic cholangitis
- Introduction
- Management of patients with acute cholangitis
- Indications and contraindications
- Specific treatment of intrahepatic stones
- Techniques for cholangioscopic stone removal and stricture management
- Management of procedure-related adverse events
- Long-term management of RPC and the role of surgery
- References
- 50. Cystic lesions of the pancreas to include ablation
- Introduction
- Prevalence of pancreatic cystic neoplasms
- Types of pancreatic cystic lesions
- Diagnosis
- Endoscopic ultrasound–guided through-the-needle biopsy
- Eus-guided pancreatic cyst ablation
- Conclusion
- References
- 51. Unexplained acute pancreatitis and acute recurrent pancreatitis
- Pathophysiology and role of ERCP, EUS, and MRCP
- Diagnostic findings and timing of ERCP, EUS, and MRCP
- Occult gallstone disease
- Sphincter of Oddi dysfunction (see Chapter 46)
- Differences in defining study outcomes
- Pancreas divisum (see Chapter 34)
- Choledochocele
- Tumors
- Other anatomic causes
- Genetic mutations
- Autoimmune pancreatitis
- Yield of ERCP, MRCP, and EUS for IAP and IARP
- Outcomes of endoscopic therapy in IARP
- Conclusions
- References
- 52. Biliary intervention in acute gallstone pancreatitis
- Diagnosis of acute gallstone pancreatitis
- Prediction of common bile duct stones
- Assessment of severity of acute pancreatitis
- Treatment of acute gallstone pancreatitis
- Endoscopic therapy for acute gallstone pancreatitis
- Early ERCP with or without endoscopic sphincterotomy
- Role of MRCP versus endoscopic ultrasonography
- Emerging evidence: Pancreatic duct stent placement
- Algorithm for the management of acute gallstone pancreatitis
- Miscellaneous issues
- References
- 53. Pancreatic interventions in acute pancreatitis: Ascites, fistulae, leaks, and other disruptions
- Background
- Epidemiology of ductal disruption
- Classification
- Management strategies (Box 53.4)
- Management (Box 53.6)
- Adverse events (Box 53.7) (see Chapter 9)
- Summary
- References
- 54. Chronic pancreatitis: Stones and strictures
- Introduction
- Endoscopic treatment: Ductal decompression by managing stones and strictures
- Endotherapy: Current issues and future directions
- Summary
- References
- 55. Endoscopic drainage of pancreatic pseudocysts, abscesses, and walled-off necrosis
- Specific types of fluid collections
- Collections composed entirely or predominantly of liquid
- Indications for drainage of liquefied collections
- Predrainage evaluation
- Drainage techniques
- Results of endoscopic therapy of pancreatic fluid collections
- Outcome differences after endoscopic drainage of pancreatic fluid collections
- Role of endoscopic experience
- Adverse events of endoscopic therapy of pancreatic fluid collections
- References
- Index
- No. of pages: 640
- Language: English
- Edition: 4
- Published: March 28, 2024
- Imprint: Elsevier
- Hardback ISBN: 9780323933629
- eBook ISBN: 9780323933858
TB
Todd H. Baron
Affiliations and expertise
Director of Advanced Therapeutic Endoscopy
University of North CarolinaDC
David L Carr-Locke
Affiliations and expertise
Clinical Director, The Center for Advanced Digestive Care, Professor, Weill Cornell Medicine, New York Presbyterian HospitalRK
Richard A. Kozarek
Affiliations and expertise
Executive Director, Digestive Disease Institute, Virginia Mason Medical Center; Clinical Professor of Medicine, University of Washington, Seattle, WashingtonNR
Nageshwar Reddy
Affiliations and expertise
Chairman, Asian Institute of Gastroenterology and AIG Hospitals, Gachibowli, Hyderabad, India