Advanced Endoscopy Fellows Program | September 2024-Gromski

Gromski_ERCP Video Case Presentation

Pdf Summary

Dr. Mark A. Gromski presents his top ten tips for successful Endoscopic Retrograde Cholangiopancreatography (ERCP) at the Indiana University School of Medicine. Below is a summary of his vital recommendations:<br /><br />1. **Clear Indication for ERCP**: Ensure the reason for performing ERCP is unmistakable.<br />2. **Value of Mentors**: Recognize and appreciate the immense value of having mentors in the field.<br />3. **Multiple Cannulation Techniques**: Understand there are various techniques to cannulate the bile duct, enhancing flexibility in procedures.<br />4. **Practice Complication Management**: Regularly practice scenarios for troubleshooting and managing complications, such as migrated stents or post-sphincterotomy bleeds.<br />5. **Approach to Biliary Strictures**: When dealing with indeterminate biliary strictures, a more comprehensive evaluation is advisable.<br />6. **Use of the Needle Knife**: Familiarize yourself with the needle knife as it can be extremely useful during procedures.<br />7. **Routine Use of Dilation Assisted Stone Extraction (DASE)**: Implement DASE routinely for more effective stone extraction.<br />8. **Knowledge of Tools**: Have a thorough understanding of all the tools you depend on during ERCP.<br />9. **Expertise in Image Interpretation**: Become highly skilled at interpreting pancreatobiliary images for better diagnosis and treatment planning.<br />10. **Team Support**: Give importance to supporting your team as they are crucial for your success.<br /><br />Dr. Gromski emphasizes the importance of a clear rationale for each ERCP, continuous learning, and teamwork, making these tips invaluable for practitioners aiming to improve their ERCP practice.

Keywords

ERCP

Endoscopic Retrograde Cholangiopancreatography

Dr. Mark A. Gromski

Indiana University School of Medicine

cannulation techniques

complication management

biliary strictures

needle knife

Dilation Assisted Stone Extraction

pancreatobiliary images