By Peter B. Cotton
The most recent variation of the world-leading name sensible Gastrointestinal Endoscopy (published in may perhaps 2003) has a 'back to fundamentals' method - putting emphasis on perfecting the elemental concepts of endoscopy. there's now a necessity for precise useful and scientific courses to the complicated endoscopy innovations for more matured physicians.
Advanced Digestive Endoscopy: ERCP addresses essentially the most advanced diagnostic and healing approaches for endoscopists. It offers the most recent pondering and transparent guide at the concepts, which were built-in with total sufferer care.
Written through the major overseas names in endoscopy, the textual content has been expertly edited by way of Peter Cotton right into a succinct, instructive structure. provided in brief paragraphs dependent with headings, subheadings and bullet issues and richly illustrated all through with full-color images.
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Extra info for Advanced Digestive Endoscopy - ERCP
Malignant bile duct strictures can sometimes be difﬁcult to distinguish from primary sclerosing cholangitis, which classically shows multiple strictures and diffuse irregularity of the extra- and intrahepatic biliary system. In contrast, benign postsurgical strictures usually appear as smooth shortsegment stenoses. An air-ﬁlled periampullary diverticulum may compress the FUNDAMENTALS OF ERCP Fig. 11 CholangiogramaCBD stones. Common duct stones seen in different size, shape, and number. Stones can form around a migrated surgical clip.
Selected patients may need overnight observation in the hospital after sphincterotomy and stone extraction. Laboratory tests Preliminary laboratory tests including blood counts, liver biochemistry, and coagulation proﬁle should be taken prior to the procedure. Coagulopathy is corrected when necessary by IV vitamin K injection or transfusion of FUNDAMENTALS OF ERCP Fig. 18 Standard biliary papillotomy. Single lumen papillotome. Double lumen papillotome over a guidewire. Use blended current, stepwise cut in 11–12 o’clock direction.
The X-ray machine should be capable of taking spot ﬁlms. Digital units can store the images onto a computer for subsequent retrieval and review. Hard copies of selected images can be printed for reporting and ﬁling. It is essential to know the magniﬁcation Fig. 6 Fluoroscopy machine with under-couch tube. Digital C-arm for designated ERCP room. Full ﬂuoroscopy unit if shared facilities in Radiology. Remote control and foot pedal. Image capture. 25 26 CHAPTER 3 factor of the machine for correct interpretation of X-ray ﬁndings, and for measuring the size of stones and the length of strictures.