ASGE Annual GI Advanced Practice Provider Course (Virtual) - Onboarding (Day One)

Pdf Summary

ERCP and EUS are two important procedures used in the diagnosis and management of GI and non-GI diseases. ERCP, or endoscopic retrograde cholangiopancreatography, has evolved from a diagnostic to a therapeutic procedure. However, other less risky procedures such as EUS, MRCP, US, CT, and intraoperative cholangiogram have replaced the need for diagnostic ERCP in some cases.<br /><br />ERCP is indicated for conditions such as choledocholithiasis with or without cholangitis, malignant biliary obstruction, pancreatic and cholangiocarcinoma, bile leaks, biliary strictures, chronic pancreatitis, and pancreatic duct injury/leaks. Pre-procedural assessment and management of anticoagulation are important considerations, and informed consent should be obtained from patients, highlighting the risk of complications including pancreatitis, perforation, bleeding, and cardiopulmonary issues.<br /><br />EUS, or endoscopic ultrasound, is a technique used for diagnosis, staging, and management of a wide range of GI and non-GI diseases. Its use has steadily increased over time. EUS combines endoscopy with high-frequency ultrasonography to provide detailed imaging. It is indicated for diagnostic purposes such as evaluating pancreatic or gastric masses, subepithelial lesions, and bile duct dilation. It is also used for staging esophageal, gastric, pancreatic, lung, ampullary, and rectal cancers. Therapeutically, EUS can be used for pseudocyst drainage, bile duct or gallbladder drainage, celiac plexus block, and EUS-guided ERCP.<br /><br />Like ERCP, pre-procedural assessment and management of anticoagulation are important in EUS. Informed consent should also be obtained, highlighting the risk of complications such as pancreatitis, perforation, bleeding, and cardiopulmonary issues.<br /><br />In summary, ERCP and EUS are essential procedures in the management of GI and non-GI diseases. Proper patient selection, consideration of less invasive tests when possible, and early recognition and management of complications are key aspects of these procedures.

Asset Subtitle

Aaron Shiels, MD, FASGE

Keywords

ERCP

EUS

diagnosis

management

GI diseases

non-GI diseases

ultrasonography

pseudocyst drainage

anticoagulation management

complications