ERCP Bootcamp: Cutting Edge Comprehensive Training for the Team

Video Transcription

Video Summary

Dr. Shifa Umar discussed ERCP in pregnancy, emphasizing that it should be reserved for strong therapeutic indications such as symptomatic choledocholithiasis, cholangitis, gallstone pancreatitis, or duct trauma. The best timing is the second trimester when possible. Pre-procedure evaluation should include informed consent, obstetric consultation, fetal assessment, and noninvasive imaging such as ultrasound, MRCP without contrast, or EUS to confirm obstruction and reduce unnecessary ERCPs. She highlighted that ERCP in pregnancy requires multidisciplinary planning with an expert endoscopist, OB/anesthesia support, and radiation safety oversight. Radiation exposure from ERCP is typically far below fetal harm thresholds, but should still be minimized using low-dose fluoroscopy, brief taps, small fields, shielding, and experienced operators. She also reviewed radiation-free techniques and practical considerations for positioning, cautery, anesthesia, and post-procedure care. Overall, ERCP is considered safe and effective in pregnancy when properly indicated and performed thoughtfully.

Keywords

ERCP in pregnancy

choledocholithiasis

second trimester

fetal radiation safety

MRCP without contrast

multidisciplinary planning