ASGE Recognized Industry Associate (ARIA) Training Program for Medtronic | March 2025-Navigating Indications and Safety in ERCP

Navigating Indications and Safety in ERCP

Pdf Summary

The document is a detailed presentation by Dr. Jeffrey Lee on the topic of Endoscopic Retrograde Cholangiopancreatography (ERCP), focusing on its indications and radiation safety. Introduced in 1968, ERCP is used to image biliary and pancreatic ducts and perform therapeutic procedures like sphincterotomy and stent placement. The presentation outlines the American Society for Gastrointestinal Endoscopy (ASGE) guidelines, delineating ERCP’s use in both benign and malignant conditions. <br /><br />Benign indications encompass choledocholithiasis, primary sclerosing cholangitis, chronic pancreatitis, and post-surgical biliary strictures, among others. Malignant indications include cholangiocarcinoma and pancreatic cancer. For instance, in treating choledocholithiasis, ERCP is nearly 95% effective, with additional procedures like endoscopic sphincterotomy having a high success rate of 90%.<br /><br />The document discusses advanced ERCP techniques requiring specialized skills for conditions like cholangiocarcinoma and post-operative complications. Surgical outcomes are compared, showing ERCP's effectiveness, limits, and associated risks, such as post-procedure pancreatitis or infections. <br /><br />Part two of the document focuses on radiation safety during ERCP procedures. It details the radiation risks, especially cumulative exposure risks for clinicians, recommending protective measures like shielding and minimizing fluoroscopy time. Special considerations are given to pregnant patients, outlining strategies to perform ERCP safely without radiation, such as using ultrasonography and magnetic resonance cholangiopancreatography (MRCP).<br /><br />The presentation underscores the continuous nature of learning in therapeutic endoscopy, emphasizing practice, teamwork, and technological advancements, including artificial intelligence, in refining ERCP practices. In conclusion, the lecture highlights key safety principles and the importance of skills development in endoscopic procedures.

Keywords

Endoscopic Retrograde Cholangiopancreatography

ERCP

radiation safety

ASGE guidelines

choledocholithiasis

cholangiocarcinoma

pancreatic cancer

sphincterotomy

fluoroscopy

artificial intelligence