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A procedure that uses an endoscope to examine and x-ray the pancreatic duct, hepatic duct, common bile duct, duodenal papilla, and gallbladder.

Results: 15

Accessing the bile duct by inserting a guidewire into the pancreatic duct to prevent inflammation of the pancreas after endoscopic retrograde cholangiopancreatography (ERCP)

To compare the effects of the pancreatic duct guidewire (PGW) technique with other endoscopic techniques for gaining access to the bile duct when access to the bile duct is considered to be difficult using traditional techniques.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

What is the best sedative technique for patients undergoing endoscopic cholangiopancreatography (ERCP)?

Patients have to be given medicines to make them adequately drowsy (sedated) or unconscious (anaesthetized) to tolerate the ERCP procedure. These medicines may be administered by anaesthetic or non‐anaesthetic healthcare personnel, and there is currently some debate as to who should administer these drugs to patients for ERCP procedures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

No evidence to support or refute endoscopic retrograde cholangiopancreaticography (ERCP) with stenting in patients with malignant pancreaticobiliary diseases, awaiting surgery

Pancreatico‐biliary malignancy includes cancers of pancreas, ampulla, duodenum, and cholangiocarcinoma. There is significant morbidity and mortality related to surgery in these patients. Studies have claimed the beneficial role of biliary decompression, which can be performed via endoscopic retrograde cholangiopancreaticography (ERCP) with stent insertion pre‐surgically. The review found that pre‐surgical biliary stenting via ERCP did not improve the morbidity and mortality in patients with pancreatico‐biliary malignancy. Further evidence about its efficiency is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Endoscopic retrograde cholangiopancreatography versus intraoperative cholangiography for the diagnosis of common bile duct stones

The liver has various functions. Production of bile is one of these functions. The common bile duct (CBD) is the tube through which bile flows from the gallbladder (where bile is temporarily stored) into the small bowel. Stones in the CBD (CBD stones) can obstruct the flow of bile from the liver into the small bowel. Usually such stones are formed in the gallbladder and migrate into the CBD. Obstruction of the flow of bile can lead to jaundice (yellowish discolouration of skin and white of the eyes, and dark urine), infection of the bile duct (cholangitis), and inflammation of the pancreas (pancreatitis), which can be life threatening. Various diagnostic tests can be performed to diagnose CBD stones. Depending upon the availability of resources, these stones are removed endoscopically (a tube inserted into the stomach and upper part of small bowel through mouth; usually the case), or may be removed as part of the laparoscopic operation (key hole surgery) or open operation performed to remove the gallbladder (cholecystectomy; it is important to remove the gallbladder since the stones continue to form in the gallbladder and can cause recurrent health problems). If the stones are removed endoscopically, presence of stones is confirmed by endoscopic retrograde cholangiopancreatography (ERCP) (injection of dye into the CBD using an endoscope) before endoscopic removal of CBD stones. Alternatively, intraoperative cholangiography (IOC) (injection of dye into the biliary tree during an operation to remove the CBD stones, usually combined with an operation to remove gallstones) can be performed to detect CBD stones prior to operative removal of the stones. We performed a thorough search for studies that reported the accuracy of ERCP or IOC for the diagnosis of CBD stones. The evidence is current to September 2012.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Surgical versus endoscopic treatment of bile duct stones

Gallstones are a common problem in the general population and commonly cause problems with pain (biliary colic) and gallbladder infections (acute cholecystitis). Gallstones can sometimes migrate out of the gallbladder and become trapped in the tube between the gallbladder and the small bowel (common bile duct). Here, they obstruct the flow of bile from the liver and gallbladder into the small bowel and cause pain, jaundice (yellowish discolouration of the eyes, dark urine, and pale stools), and sometimes severe infections of the bile (cholangitis). Between 10% and 18% of people undergoing cholecystectomy for gallstones have common bile duct stones.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for the diagnosis of common bile duct stones

Bile, produced in the liver and stored temporarily in the gallbladder, is released into the small bowel on eating fatty food. The common bile duct (CBD) is the tube through which bile flows from the gallbladder to the small bowel. Stones in the CBD (CBD stones) are usually formed in the gallbladder before migration into the bile duct. They can obstruct the flow of bile leading to jaundice (yellowish discolouration of skin, whites of the eyes, and dark urine), infection of the bile (cholangitis), and inflammation of the pancreas (pancreatitis), which can be life threatening. Various diagnostic tests can be performed for the diagnosis of CBD stones. Depending upon the availability of resources, these stones are removed endoscopically (usually the case) or may be removed as part of the operation performed to remove the gallbladder (it is important to remove the gallbladder since the stones continue to form in the gallbladder and can cause recurrent problems). Prior to removal, invasive tests such as endoscopic retrograde cholangiopancreatography (ERCP) or intraoperative cholangiography (IOC) can be performed to detect CBD stones. However, before performing such invasive tests to diagnose CBD stones, non‐invasive tests such as endoscopic ultrasound (EUS) (using ultrasound attached to the endoscope) and magnetic resonance cholangiopancreatography (MRCP) are used to identify people at high risk of having CBD stones so that only those at high risk can be subjected to further tests.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Prophylactic cholecystectomy should be offered to patients whose gallbladders remain in‐situ after endoscopic sphincterotomy and common bile duct clearance

Surgical removal of the gallbladder is done routinely. Stones in the common bile duct usually come from the gallbladder and can be harmful. The usual treatment for gallstones that are in the common bile duct is endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy. ERCP is an endoscopic procedure to remove stones from the common bile duct. More stones may enter the common bile duct from the gallbladder but it is not clear if the gallbladder should be removed preventively (prophylactic cholecystectomy) or if a wait‐and‐see policy (cholecystectomy deferral) would be better. We included 5 randomised trials with 662 participants out of 93 publications identified through the literature searches. The number of deaths was 47 in the wait‐and‐see group (334 patients) compared with 26 in the prophylactic cholecystectomy group (328 patients). This review of randomised clinical trials suggests that early removal of the gallbladder decreases the risk of death or of complications from gallstones. The number of patients (662) reviewed in this report prevents some of the subgroup analyses from being conclusive. Further clinical trials, particularly of high‐risk patients, would solve this problem.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Antibiotics may prevent complications following endoscopy of the bile or pancreatic ductal systems

Endoscopic retrograde cholangiopancreatography (ERCP) involves cannulating the biliary system in order to diagnose bile or pancreatic duct obstruction. It then affords the possibility of relieving this obstruction using various interventions. Traditionally, prophylactic antibiotics have been administered to decrease the incidence of infective complications as a result of interfering with a normally sterile biliary tree. Preventing overuse of antibiotics and consequent bacterial resistance must be aimed. If antibiotics do not prevent complications following ERCP, then antibiotics should not be used.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Techniques for gaining access to the bile duct for the prevention of post‐procedure pancreatitis

Endoscopic retrograde cholangiopancreatography (ERCP) combines endoscopy and x‐ray to diagnose and treat problems of the bile and pancreatic ducts. With the patient under sedation, an endoscope is passed down the oesophagus, through the stomach, and into the duodenum where the opening of the bile and pancreatic ducts (papilla) is located. A catheter is then inserted through the endoscope and through the papilla into the bile duct. Contrast dye is then injected into the bile duct and x‐rays are taken to look for gallstones or blockage. However, the major risk of ERCP is the development of pancreatitis due to irritation of the pancreatic duct by the contrast material or catheter, which can occur in 5% to 10% of all procedures. This may be self‐limited and mild, but it can also be severe and require hospitalisation. Rarely, it may be life threatening. There are additional small risks of bleeding or making a hole in the bowel wall.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Endoscopy for the treatment of acute gallstone pancreatitis

Acute pancreatitis refers to sudden inflammation of the pancreas associated with severe abdominal pain. The most common cause is transient blockage of the pancreatic or bile duct (or both) by gallstones. Most attacks of acute pancreatitis are mild, and most patients recover uneventfully with medical management. However, a small proportion of patients have a more severe course requiring intensive medical management.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Gallbladder Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of gallbladder cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 30, 2016

Pancreatic Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of pancreatic cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 30, 2016

Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of pancreatic neuroendocrine tumors (islet cell tumors).

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 30, 2015

Bile Duct Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of bile duct cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 18, 2016

Unusual Cancers of Childhood Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of unusual cancers of childhood such as cancers of the head and neck, chest, abdomen, reproductive system, skin, and others.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 10, 2016

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