Intro to ERCP
biliary
True or False: Gabexate and Somatostatin are not currently available in the United States.
True
Bleeding occurs primarily after ________.
sphincterotomy
True or False: Perforation is now reported in between 3-4% of ERCPs.
What is cholangitis?
Infection of the bile duct
Using a wire and/or contrast, ________ is used to visualize the bile and pancreatic ducts.
True or False: Older, female patients are more likely to get Post-ERCP Pancreatitis than younger ones.
False
Presentation of hemorrhage may be delayed up to how many days after procedure?
A. 5 days
B. 7 days
C. 9 days
D. 10 days
D. 10 days
Experienced endoscopists may place what to close a definite leak?
Endoscopic clip
What is cholecystitis?
Infection of the gallbladder
What are 2 abnormalities of the biliary system that may cause ERCP to be performed?
Gallstones
Bile duct blockage
Jaundice
Undiagnosed upper abdominal pain
Cancer
Which of the following is NOT a risk reduction strategy of Post-ERCP Pancreatitis?
A. Pharmacology
B. Patient Selection
C. Post-ERCP Monitoring
D. Procedural Technique
C. Post-ERCP Monitoring
Injection of _________ at the time of sphincterotomy may reduce the risk of delayed bleeding.
epinephrine
If perforation is suspected during a sphincterotomy, injecting a small amount of _______ while pulling the papillotome through the incision over a guide wire will confirm or exclude extravasation and allow proactive treatment.
The principle recommendation regarding prevention and treatment of cholangitis is obtaining successful and complete _______ _______.
biliary drainage
ERCP may eliminate the need for _______ intervention in some cases.
surgical
Pancreatic ______ placement can reduce the risk of Post-ERCP Pancreatitis from 26% to 7%.
stent
True or False: If a bleeding vessel is clearly visualized and access is adequate, another option would be placing a clip.
True
Bowel wall perforations are generally treated ______; whereas guide wire or stent related perforations are usually treated ______ by providing adequate ductal drainage.
surgically; endoscopically
What are the 4 main complications of ERCP?
Pancreatitis
Hemorrhage
Perforation
Infection
What study proved that Post-ERCP Pancreatitis was higher with nurse controlled wire-guided cannulation vs. physician controlled?
Buxbaum
In more severe cases, epinephrine injection should be followed by ______ therapy such as bipolar coagulation.
thermal
Which of the following is NOT a way to reduce the risk of perforation?
A. Inject more contrast
B. Wires of stents
C. Using special caution with needle-knife papillotomy
D. Limit the length of the cutting wire in contact with the tissue
A. Inject more contrast