What is ERCP (CBD/PD Stenting)?
Endoscopic Retrograde Cholangiopancreatography (ERCP) is an advanced endoscopic procedure that combines X-ray imaging with endoscopy to diagnose and treat conditions of the bile ducts and pancreatic ducts. CBD/PD stenting involves placing stents in the Common Bile Duct (CBD) or Pancreatic Duct (PD) to maintain drainage.
Clinical Applications
- Bile duct obstruction
- Pancreatic duct strictures
- Chronic pancreatitis
- Post-surgical complications
- Biliary leaks
Types of Stents
- Plastic stents:
- Cost-effective
- Temporary placement
- Regular replacement needed
- Metal stents:
- Self-expanding
- Longer patency
- Higher initial cost
Procedure Steps
- Endoscopic visualization of papilla
- Cannulation of desired duct
- Contrast injection and fluoroscopy
- Guide wire placement
- Stent deployment
Success Rates and Outcomes
- Technical success rates exceed 90% for biliary stenting
- Stricture resolution rates of 75-77% at 24 months with both multiple plastic stents and fully covered self-expanding metal stents
- Reduced need for repeat procedures with metal stents
Potential Complications
- Post-ERCP pancreatitis
- Cholangitis
- Bleeding
- Stent migration
- Stent occlusion
Follow-up Care
- Regular monitoring of liver function
- Scheduled stent exchanges for plastic stents
- Assessment of symptoms improvement
- Management of underlying conditions
- Long-term surveillance when needed