Cancer Treatment Centers of America

Pancreatic cancer: ERCP

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Dr. Leon Yoder: An ERCP is an endoscopic or scope technique. It stands for endoscopic retrograde cholangiopancreatography. This technique allows us to look at the bowel ducts and at the pancreatic duct. And thereby, we can see if there's any obstruction, that means, if there's any blockage of one of those ducts, that we can go into that area now and look at it much clearer, define it much better and seeing if it's a stricture, which is narrowing, or if it's a tumor that's blocking, or if it's a lymph node that's pushing against one of those structures. And if there is such a case where it's obstructing, then we can do something about that.

Oftentimes, in conjunction with an ERCP, we do cholangioscopy. That means, we have the scope down into the small intestine, and now we can take a smaller scope through the ERCP scope, and look directly up into the bowel duct. This gives us an opportunity to see actually what's in the bowel duct. If we think there's an obstruction there by a tumor inside the duct or if there's pressure from the outside, we can tell that. We can tell if that duct is inflamed and we can take biopsies if we have to. We can take brushings of that if we think there are malignancies up in that bowel duct.

So with ERCP cholangioscopy, it's a very good technique for looking at the bowel ducts and taking care if there's any problems with strictures, and if there's any tumors in the area. It allows us to look at the pancreas to see if there's any structural abnormalities, meaning that it may be strictured, it may be blocked off. We can do brushings of the pancreatic duct to see if there are any cancer cells in that. We could also place stents. Now stents are little tubular structures that are very similar to heart stents. When you have coronary artery disease, your cardiologist may say, "You need a stent for your heart." This would be the same kind of stent. It's a little tubular structure that we can put in the bowel duct or the pancreas. We can relieve an obstruction. Thereby, you have good flow of the normal bile pattern or of the pancreatic juices that will flow normally back into the intestinal tract. It makes a huge difference because, oftentimes, if those structures are blocked, you feel sick, you're nauseated, you can't eat. It may cause a lot of pain.

Endoscopic retrograde cholangiopancreatography enables doctors to identify blockages in the pancreatic and bowel ducts. Listen to Dr. Leon Yoder explain how this tool is used to remove blockages, open up the ducts and retrieve tissue samples to examine for cancer cells.

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