What is the procedure of ERCP and PTC?


There are often some cases where the pancreatic cancer may cover the bile duct and this can cause jaundice. In order to prevent that, the doctors try to put a stent in the bile duct.

This is also known as the endoscopic biliary stenting and the procedure through which the stent is inserted is known as the ERCP. Here a tube is used which has a camera in the end and this is inserted to a patient’s body through the throat.

But before the ERCP is done, the patient must tell the doctor that if they are taking any kind of medicines like the ones which are blood thinners or some medicines regarding diabetes. Then the doctors canadvise how to take these medicines before the procedure.

The patient will be asked not to drink or eat anything for at least 6 hours before the procedure but yes one can have very small sips of water from 2 hours before the procedure. This is done only to make sure that the stomach and the duodenum both are empty. The patient is put on a sedative before the stent goes in. This makes the patient to relax a bit.

There is a flexible tube which has both the light and camera at one end of it and it is known as the endoscope. This is the thing that is out through the patient’s mouth and then passed down to the stomach and the camera that is attached to it gets some screen shots of the interior of the human body. Then the stent goes inside the bile duct with the help of a small wire and when it reaches the right position then the wire is removed. The stent must unblock the bile duct and then it will start draining normally. This entire process takes around half an hour to 40 minutes to complete.

There are some people who are not able to put the stent with the help of ERCP. For them there is a different method. One has to go through a PTC where the stent is passed through the wall of tummy and the liver. Then it is inserted into a bile duct with the help of a needle. This process is very common when the blockage is there on the upper portion of the bile duct which is near the liver.
The PTC needle which is used here is guided with the help of the X ray pictures on the computer screen. A particular dye is injected in the needle so that the blockage can become prominent on the screen. Then the wire is put on the needed and then the stent is placed in the position.

Once the entire procedure is done, then a blood test is done by the doctors to make sure whether there are any inflammations in the pancreas or not. These days’ plastic biliary stents are also used instead of metal stents because they are less hazardous and they are also easy to insert.


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