Most patients undergo ERCP to diagnose pancreatic and bile ducts which act as passageways for bowel movement, and treat complications in the gall bladder, bile duct and pancreas. However, 10-15% of these patients are at risk of post-ERCP Pancreatitis (PEP).
Patients should be informed of this alarming risk before they sign a consent for ERCP procedure. If the endoscopist fails to inform the patient, then this could be grounds for filing an ERCP malpractice.
PEP risks are also assessed on the kind of ERCP procedure performed. There are usually different types of ERCP which include:
1. Endoscopic Sphincterotomy
This type of procedure is done using a needle-knife papillotome which is executed towards patients with Type III Sphincter of Oddi dysfunction. This process cuts through the muscle of the bile ducts to the pancreatic ducts to allow better drainage. Cutting multiple muscle tissues of the ducts could also be life-threatening when not handled with care.
2. ERCP with Stent
This type of method uses a stent or drainage tube that is placed in the pancreatic duct or bile duct to relieve blockage caused by tumors or scar tissues. The stent could either be plastic or metal and stays on the ducts until after another ERCP procedure is done as advised by your doctor.
3. Tissue Sampling
In this process, tissue samples from the ducts or papilla are collected and examined for cancer. This method is not a hundred percent accurate.
4. Stone Removal through ERCP Scope
After Sphincterotomy, your doctor can opt for stone removal through the ERCP Scope which pulls stones out of the ducts and moves them to waste disposal areas which are released through bowel movement. Huge stones may need to be crushed through a specialized basket.
5. Endoscopic Papillary Balloon Dilation
This is performed using ERCP catheters with dilated balloons which are positioned in the ducts. The balloons are then inflated to ease out the narrow passageway. However, excessive ballooning could damage the ducts and is considered an ERCP malpractice.