Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that carries certain risks for patients and presents challenges for physicians. The slightest error by the physician can have horrific consequences.
To address this issue, industry professionals and researchers have worked to identify specific challenges and come up with solutions and strategies that can help physicians make the procedure safer.
Comprehensive Cleaning Procedures for Endoscopes
Infection is one of the main risk factors for ERCP. The endoscopes used for ERCP have moving mechanisms that may present cleaning and reprocessing challenges. Any errors in cleaning parts of the endoscope used for ERCP can cause severe infections, potentially becoming life-threatening.
To minimize these risks, it’s critical for physicians understand the manufacturers’ cleaning and reprocessing instructions for this highly-sensitive equipment. Developing comprehensive and strictly-followed cleaning procedures can help physicians and practice offices reduce risk and improve health outcomes.
Administration of Antibiotics
Another approach to mitigate the risks of patient infections is to administer antibiotics before and after the ERCP procedure. Prescribing antibiotics before the procedure can help to prevent cholangitis if complications occur during the procedure.
Whether antibiotics are necessary after the procedure can be determined on a case-by-case basis.
Management of Strictures
Strictures of the bile duct can be complex or long, making it difficult to move the endoscope through the gastrointestinal (GI) tract. In some cases, the best way to address this issue is to recruit outside parties such as a radiologist or an endoscopist with experience in endoscopic ultrasound, who can assess the extent of complications and help come up with strategies for treatment.
Techniques to Remove Stones
ERCP is often performed to identify and remove gallstones, but sometimes stones present unique challenges. Stones that are too large or that are embedded in the bile duct walls can be tough to remove using traditional ERCP techniques.
This can be painful for patients and can cause internal tears and other injuries if not addressed properly.
Experts have come up with specific ERCP techniques that can be useful when stone removal is not as straightforward. Utilizing these new techniques can help patients to stay injury and infection-free, while also avoiding visits to specialists and subsequent surgeries or procedures.
Making Strides for the Future
By making an effort to learn new strategies that can help minimize ERCP risks and complications, physicians can improve patient outcomes in the coming years. Only by addressing challenges and working to resolve them will doctors be able to make this potentially hazardous procedure safer.