Procedures
The main medical procedures carried out by the Endoscopy Department
Colonoscopy
ERCP
Gastroscopy
Colonoscopy
Colonoscopy is a crucial medical procedure used to examine the large intestine (colon) and rectum for any abnormalities, including polyps, inflammation, or signs of colorectal cancer. This minimally invasive procedure plays a pivotal role in early detection, prevention, and treatment of various gastrointestinal conditions. In this article, we will explore the process of colonoscopy, its significance, and what to expect before, during, and after the procedure.
From NHS Choices:
ERCP
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a crucial medical procedure used to diagnose and treat disorders of the bile ducts, pancreas, and liver. It combines the power of endoscopy and fluoroscopy to visualise and manipulate these vital structures.
Understanding ERCP
ERCP is primarily employed to evaluate and treat conditions affecting the bile ducts, pancreas, and gallbladder. These may include gallstones, pancreatic cancer, bile duct strictures, pancreatitis, and other disorders causing blockages or abnormalities in these organs.
Procedure Overview
Preparation
Before the procedure, the patient may be asked to refrain from eating or drinking for several hours to ensure the stomach is empty. An intravenous line may also be inserted to administer necessary medications and fluids during the procedure.
Sedation
ERCP is performed under conscious sedation, during which the patient is kept comfortable and relaxed while remaining conscious. Medications are administered through the intravenous line to induce a state of deep relaxation and minimal discomfort.
Endoscope insertion
The endoscope, a thin, flexible tube with a light and camera at its tip, is carefully inserted into the mouth and guided through the oesophagus and stomach into the duodenum—the first part of the small intestine.
Cannulation and contrast injection
Once the endoscope reaches the duodenum, a small plastic catheter is inserted through the endoscope into the opening of the bile or pancreatic ducts. A contrast dye is then injected, which allows these ducts to be visualised clearly on fluoroscopy – a real-time X-ray imaging technique.
Imaging and evaluation
The fluoroscope generates detailed images of the bile ducts, pancreatic ducts, and surrounding structures, aiding in the identification of any abnormalities or blockages. If necessary, additional interventions can be performed during the same procedure, such as removing gallstones, placing stents to relieve obstructions, or taking biopsies for further analysis.
Completion and recovery
After the procedure, the endoscope is gently removed. Patients are then monitored for a brief period to ensure their vital signs are stable. As the sedation wears off, patients may experience some bloating, mild discomfort, or a sore throat, which usually subside within a day.
Benefits of ERCP
Accurate diagnosis
ERCP allows for precise visualisation of the bile ducts, pancreas, and related structures, enabling the detection of various disorders that may not be identified through other imaging techniques.
Therapeutic intervention
In addition to diagnosis, ERCP enables the treatment of conditions such as gallstone removal, stent placement, and dilation of strictures. This eliminates the need for additional invasive procedures in many cases.
Risks and complications
While ERCP is generally considered safe, there are potential risks involved, including:
Pancreatitis
The most common complication, pancreatitis, occurs in a small percentage of patients and is typically mild. Severe cases, although rare, may require hospitalisation and treatment.
Bleeding
Occasionally, ERCP can cause bleeding, especially if biopsies or interventions are performed. However, this risk is generally low.
Infection
Although rare, infection can occur following ERCP. Antibiotics may be administered before the procedure to minimise this risk if you are deemed high risk by your doctor.
Conclusion
ERCP is an invaluable diagnostic and therapeutic procedure used to evaluate and treat disorders of the bile ducts, pancreas, and liver. It combines endoscopy and fluoroscopy to provide detailed imaging and the ability to perform interventions simultaneously. With its ability to accurately diagnose and treat various conditions, ERCP has significantly reduced the need for more invasive procedures. While there are potential risks involved, they are generally low, and the benefits of ERCP outweigh the risks in most cases.
As always, it is essential to consult with a healthcare professional to determine the suitability of ERCP for individual circumstances.
Gastroscropy
Gastroscopy is a valuable diagnostic and therapeutic tool used to assess and treat various upper gastrointestinal conditions. By providing a clear view of the oesophagus, stomach, and duodenum, it enables doctors to identify abnormalities, perform biopsies, and address certain issues during the same procedure.
With its minimally invasive nature and quick recovery time, gastroscopy plays a crucial role in maintaining digestive health and improving patient outcomes. If you have any concerns or questions, be sure to consult your healthcare provider, who can provide personalised information and guidance based on your specific situation.