ASGE Masterclass: Endoscopic Retrograde Cholangiopancreatography (ERCP) Virtual | January 2022-4

4_Faulx Pre ERCP Procedure Planning

Pdf Summary

This document discusses the importance of pre-ERCP (Endoscopic Retrograde Cholangiopancreatography) procedural planning. It emphasizes the need for a safe environment, appropriate indications for the procedure, and recognition of patient-related factors that can influence the outcome. The document highlights the importance of training and experience in performing ERCP, with recommended numbers of supervised procedures to achieve competency. It also provides resources for ongoing training.<br /><br />The document emphasizes the importance of patient preparation, including assessing their condition, comorbidities, medications, and anatomy. Informed consent is discussed, including the need for a process that involves the patient and ideally includes a family member or representative. The document provides information on the risk factors for post-ERCP pancreatitis and the importance of careful patient selection. It also mentions the recent outbreaks of CRE (carbapenem-resistant Enterobacteriaceae) related to endoscope contamination and suggests considering this information in the informed consent process.<br /><br />Pre-procedure imaging is discussed as an important aspect of pre-ERCP planning. The document also mentions the use of electrosurgical current and the challenges posed by patients, such as sedation, supine positioning, and managing coagulopathy and anti-platelet agents. Staffing challenges for ERCP procedures are addressed, along with resources for training and maintaining well-trained staff.<br /><br />In summary, the document emphasizes the importance of careful patient selection, tailored informed consent, review of available imaging, and consideration of anesthesia/sedation needs in the pre-ERCP planning process. It also highlights the importance of ongoing training and experience in performing ERCP.

Keywords

pre-ERCP procedural planning

safe environment

appropriate indications

patient-related factors

training and experience

informed consent

post-ERCP pancreatitis

endoscope contamination

pre-procedure imaging

sedation