ASGE Annual GI Advanced Practice Provider Course (On-demand) (Day One)

Video Transcription

Video Summary

The transcript reviews ERCP (endoscopic retrograde cholangiopancreatography) and EUS (endoscopic ultrasound), focusing on definitions, indications, contraindications, preparation, informed consent, procedural components, and post-procedure care. ERCP combines side-viewing endoscopy with fluoroscopy to inject contrast retrograde into the bile and pancreatic ducts, now used mostly therapeutically rather than diagnostically due to safer imaging options (MRCP, EUS). Key ERCP uses are “plumbing” problems: removing bile duct stones, treating strictures (dilation and stenting), managing leaks/fistulas, and obtaining tissue (brushings/biopsy; sometimes cholangioscopy). Adverse events include pancreatitis (notably common), bleeding, perforation, and hypoxia; rectal NSAIDs reduce post-ERCP pancreatitis risk. Anticoagulation management depends on planned high-risk maneuvers (sphincterotomy/dilation). EUS has evolved from diagnostic staging to major therapies (FNA/FNB, pseudocyst drainage, necrosectomy, anastomosis creation with lumen-apposing stents, variceal coiling, nerve blocks). Post-procedure care emphasizes early diet as tolerated, monitoring response/complications, and structured follow-up since endoscopy is one tool within comprehensive patient care.

Asset Subtitle

John A. Martin, MD, FASGE

Keywords

ERCP

endoscopic ultrasound (EUS)

biliary obstruction and bile duct stones

endoscopic sphincterotomy and biliary stenting

post-ERCP pancreatitis prevention (rectal NSAIDs)

EUS-guided FNA/FNB and therapeutic interventions