E

endoscopic retrograde cholangiopancreatogra-
phy (ERCP) An endoscopic procedure that
allows diagnostic as well as therapeutic procedures
involving the DUODENUM, pancreatic duct, and
common BILEduct. After administering a sedative
the gastroenterologist inserts the flexible, lighted
endoscope through the MOUTH, passing it down the
ESOPHAGUSand through the STOMACHto the duode-
num. While advancing the endoscope the gas-
troenterologist examines these structures. Once
the endoscope is in the duodenum, the gastroen-
terologist inserts a catheter through the ampulla
of Vater and injects contrast into the common bile
duct, pancreatic duct, and right and left intrahe-
patic ducts. X-rays taken after the injection of
radiopaque dye into the ducts can show blockages
and narrowing of the ducts. Through ERCP the
gastroenterologist can take tissue samples for
biopsy, remove small gallstones, and perform
other treatments. ERCP takes about an hour, after
which the person rests in a recovery area for

another two to three hours until the sedative

wears off. ERCP has few risks and can help a per-

son avoid more invasive surgery.

See also BILE DUCTS; ENDOSCOPY; PANCREAS; PAN-

CREATITIS; SURGERY BENEFIT AND RISK ASSESSMENT.

endoscopy The collective term for minimally

invasive procedures that allow the doctor to view

internal organs and structures using a lighted,

flexible scope inserted through a natural body

opening or through a small incision. Endoscopy

can be diagnostic or therapeutic. Most endoscopic

procedures require preparation before the proce-

dure, sedation during the procedure, and super-

vised recovery after the procedure.

The primary risks of endoscopic procedures are

minimal, consisting of primarily INFECTION or

bleeding that results from unintended ABRASIONSto

the tissues. A very rare but serious complication of

endoscopic procedures of the bowel is perforation,

in which the endoscope goes through the wall of

38

COMMON GASTROINTESTINAL ENDOSCOPY PROCEDURES

Procedure Description and Purpose Preparation
anoscopy short, rigid scope for viewing the anal canal bowel evacuation (LAXATIVESor ENEMAbefore
inserted through the ANUS the procedure)
diagnose HEMORRHOIDS, ANAL FISSURE, anal
polyps, INFECTION

colonoscopy flexible scope with a camera for viewing the multiday bowel preparation, including dietary
full length of the COLON restrictions and a potent laxative to
inserted through the anus completely clear the colon
detect and remove INTESTINAL POLYP intravenous sedation and pain medication
diagnose inflammatory or infectious conditions during procedure
evaluate bleeding or possible ILEUS(intestinal
obstruction)
biopsy suspicious growths or tumors