Endoscopic Ultrasound vs. ERCP

Endoscopic ultrasound and ERCP procedure are both medical techniques that are used to examine parts of a patient’s GI tract. They are relatively similar to each other as both involve the use of an endoscope. The main difference between the two is that endoscopic ultrasound utilizes high-frequency sound waves to generate a virtual image and ERCP procedure uses a video camera. These two techniques are commonly used for examining organs like the liver, gall bladder, and pancreas.

Endoscopic Ultrasound Procedure

During an endoscopic ultrasound, a thin flexible tube, called the endoscope, is inserted into the small intestine of the patient through their esophagus. The tube must pass down the patient’s esophagus and through their stomach. Once in the stomach, the endoscope emits high-frequency sound waves from a built-in miniature probe. The sound waves are able to pass through the patient’s stomach lining and duodenum to render a visual of the pancreas and other surrounding areas.

Another part of this technique involves biopsy, if necessary. Endoscopic ultrasound can be used to acquire a needle biopsy of the patient’s pancreas or of sample fluid from a pancreatic cyst. This is done with a thin needle that extends from the endoscope into the pancreas. The ultrasound is able to continue during this process. The technique is called fine need aspiration.

Endoscopic Ultrasound Complications

Endoscopic ultrasound is considered a very safe procedure but some problems can occur. They are less common if the procedure is performed by an experienced physician with specialized training. The most common complaint from endoscopic ultrasound is sore throat from the insertion of the endoscope. Air can also become trapped in the stomach from this. Many patients are also adversely affected by the sedatives used before the procedure.

One of the most uncommon but dangerous complications is tearing of the stomach or duodenum, called a perforation. If this occurs, the patient will usually require surgery to repair it. Problems can also occur from fine needle aspiration such as bleeding, pancreatitis, and infection. Antibiotics are routinely prescribed to prevent the infection in patients.

ERCP Procedure Comparison

There are only very slight differences between ERCP procedure and endoscopic ultrasound. Since both techniques revolve around the use of an endoscope, the risks for both procedures are essentially the same. There is no added risk to the patient from the ultrasound or video recorder. The only extra risk is the potential for infection from fine needle aspiration during endoscopic ultrasound. However, in this case the risk of infection from fine needle aspiration is worth the tissue sample for diagnosis from endoscopic ultrasound.


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