ERCP 101
What are the 2 reasons for an ERCP?
Stones & Strictures
What are the two kinds of biliary stones?
Cholesterol Stones and Pigment Stones
True or False: Short and long wire can be used with Spyglass
True
What does RX stand for?
Rapid Exchange
With plastic stents - what side of the stent gets loaded first?
The side with the black marker
One of the main concerns with an ERCP:
Post ERCP Pancreatitis
What are 2 symptoms a patient may have if they have a stone?
abdominal pain
nausea
vomiting
Jaundice
T or F: Spyglass should only be used with saline
TRUE!
What can be placed during an ERCP if we inject into the PD to help prevent pancreatitis?
Pancreatic Stent
What dilation handle is used with the hurricane balloon?
ENCORE
What are the 3 things a sphincterotome can do?
- Gain access to CBD
- Cut (sphincterotomy
- Inject Dye
What are two potential causes of malignant strictures?
Pancreatic Headmass
Cholangiocarcinoma
In which year was the Spyglass DS system launched?
2015! 10 year anniversary of SPYYY
Brushing gets you ___ sample for pathology
Spy Bite gets you ___ sample for pathology
Cell (cytopathology)
Tissue (histopathology)
What is the benefit of using a metal stent over a plastic stent for a patient that is coming back every 3 months for an ERCP due to obstruction causes by stones?
Avoid bringing the patient back constantly - plastic stent has to be exchanged every 4-6 weeks. Metal stent stays in for up to 12 months.
What is the benefit of EXALT?
...
What can product can ablate tissue in the biliary tree?
Habib
What percent of stone cases are considered difficult?
10-15%
What % of benign strictures occur post cholecystectomy?
80%
The Wallflex biliary metal stents come in 3 options - what are they?
Fully covered
Partially covered
Uncovered
When using EXALT ... what do you need to modify to help Dr. Levin during the case?
The settings on the monitor
Draw and label the biliary tree anatomy:
looking for 8 labels
!
What does DS stand for?
Digital Simple
How does EHL for Spyglass work?
Uses electricity with saline to blast the stones
What is a physician concern with using a fully covered stent in the CBD?
Blocking the cystic duct