By Peter B. Cotton
Complicated Digestive Endoscopy: ERCP addresses the most advanced diagnostic and healing tactics for endoscopists. It offers the most recent considering and transparent guideline at the thoughts, which were built-in with total sufferer care. Written by means of the major overseas names in endoscopy, the textual content has been expertly edited by means of Peter Cotton right into a succinct, instructive layout. provided in brief paragraphs based with headings, subheadings and bullet issues and richly illustrated all through with full-color photos
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Additional info for Advanced digestive endoscopy : ERCP
Bile duct stones (Fig. 11) Stones within the bile duct may be demonstrated initially as a meniscus sign upon contrast injection and subsequently as ﬁlling defects. They are round or faceted depending upon their origin. It may be necessary to change the scope position into a long scope position to expose the mid/distal CBD, an area otherwise overlapped by the scope. Rarely, parasites such as Clonorchis sinensis or Ascaris lumbricoides may be seen as unique ﬁlling defects in the extra- or intrahepatic bile ducts.
Metro tracer wire from Wilson Cook). The ﬂexible tip guidewire is inserted through a catheter or a sphincterotome and 5 mm of the tip is pushed gently in the direction of the CBD. It is important that the endoscopist or an experienced assistant performs the initial gentle probing (or exploration) at the papillary oriﬁce with the guidewire as the feel and control of the catheter/guidewire are important. When the tip of the guidewire is advanced without any resistance, the catheter is passed over the guidewire into the ductal system.
B) ERCP showing the pancreatico-biliary system and gallbladder. Fig. 8 Personnel protectiona OSHA regulation. Gowns, gloves (double), shoe cover, face shields or mask, lead apron and collar, X-ray badge, and lead lining for room and warning signs. facing the ﬂuoroscopy unit during screening. Individuals who need to turn around during ﬂuoroscopy should have both front and back protection. To reduce the weight of the lead apron on the shoulder, a skirt and a vest can be used. A lead collar should be worn to protect the thyroid gland, and lead glasses are recommended, especially if a ﬂuoroscopy unit with an over-couch tube is 27 28 CHAPTER 3 used.