Advanced digestive endoscopy : ERCP

Cover......Page 1
Advanced Digestive Endoscopy: ERCP......Page 4
Contents......Page 6
List of contributors......Page 8
Preface......Page 10
Historical background......Page 12
The changing world of pancreatico-biliary medicine......Page 13
The future......Page 16
References......Page 17
ERCP is challenging, and not for all gastroenterologists......Page 20
What is ‘competence’ in ERCP?......Page 21
Degree of dif.culty and expertise......Page 22
Towards more structured training......Page 23
Ongoing competence and re-credentialing......Page 24
References......Page 26
Introduction......Page 28
Section I: Preparation for ERCP......Page 30
Section II: Diagnostic and therapeutic ERCP......Page 46
Outstanding issues and future trends......Page 89
References......Page 90
Teamwork......Page 92
Recording and reporting......Page 94
References......Page 97
Background......Page 99
Pathogenesis......Page 100
Clinical presentations......Page 101
Diagnosis......Page 103
Management for CBD stones......Page 106
Complications......Page 108
Controversies......Page 109
Alternative approaches to CBD stones......Page 112
The challenge: giant CBD stones......Page 114
Intrahepatic duct stones......Page 118
ERCP and sphincterotomy in Billroth II gastrectomy......Page 120
Cholangitis......Page 121
Outstanding issues and future trends......Page 126
References......Page 127
ERCP in diagnosis of pancreatico-biliary malignancies......Page 131
Intraductal ultrasound......Page 137
Magnetic resonance cholangiopancreatography......Page 138
Palliation of inoperable pancreatico-biliary malignancies......Page 139
ERCP in the management of ampullary neoplasms......Page 147
Outstanding issues and future trends......Page 148
References......Page 149
Introduction......Page 153
Classi.cation of bile duct injuries......Page 154
Diagnostic protocol......Page 156
Management of bile duct leakage after cholecystectomy......Page 158
Surgical treatment of postoperative biliary strictures......Page 161
Percutaneous treatment of postoperative strictures......Page 162
Endoscopic treatment of postoperative biliary strictures......Page 163
?......Page 169
Metal stents for benign strictures......Page 170
A more aggressive treatment protocol?......Page 171
Outstanding issues and future trends......Page 172
References......Page 173
De.nitions......Page 176
Epidemiology......Page 177
Clinical presentation......Page 180
Initial evaluation......Page 181
Non-invasive diagnostic methods for SOD......Page 182
Invasive diagnostic methods for SOD......Page 185
Sphincter of Oddi manometry......Page 186
Therapy for SOD......Page 194
SOD in recurrent pancreatitis......Page 201
Outstanding issues and future trends......Page 204
References......Page 205
Introduction......Page 210
Interdisciplinary management: complex ERCP......Page 211
Acute gallstone pancreatitis......Page 212
Pancreatic duct disruptions......Page 216
Acute recurrent pancreatitis......Page 218
Overall approach to unexplained acute pancreatitis......Page 236
Outstanding issues and future trends......Page 241
References......Page 242
Synopsis......Page 250
Treatments for chronic pancreatitis......Page 251
Pancreatic ductal strictures......Page 254
Pancreatic ductal stones......Page 266
Pancreatic pseudocysts......Page 277
Biliary obstruction in chronic pancreatitis......Page 278
Sphincter of Oddi dysfunction in chronic pancreatitis......Page 282
Pancreas divisum......Page 284
Outstanding issues and future trends......Page 285
References......Page 286
Synopsis......Page 292
Toxic and metabolic complications......Page 293
Pancreatic .uid collections......Page 296
Pseudocysts and abscesses......Page 297
Pancreatic necrosis......Page 303
Miscellaneous complications......Page 309
Arterial complications......Page 311
References......Page 315
Introduction......Page 320
Instruments......Page 321
Indications......Page 322
Complications......Page 323
Biliary .ndings......Page 324
Pancreatic .ndings......Page 336
References......Page 345
The risks of ERCP......Page 350
complications......Page 354
Overall complication rates......Page 359
General risk issues......Page 361
Reducing the risks of ERCP: general issues......Page 367
Pancreatitis after ERCP......Page 370
Perforation......Page 377
Infection after ERCP......Page 383
Bleeding after ERCP......Page 385
Complications of stents......Page 388
Cardiopulmonary complications and sedation issues......Page 389
Rare complications......Page 390
Late complications......Page 391
Managing adverse events......Page 394
Learning from lawsuits......Page 395
Conclusion......Page 396
Outstanding issues and future trends......Page 397
References......Page 398
INDEX......Page 416