Get Advanced Digestive Endoscopy: ERCP PDF

By Peter B. Cotton

ISBN-10: 1405120797

ISBN-13: 9781405120791

Advanced Digestive Endoscopy: ERCP addresses essentially the most advanced diagnostic and healing methods for endoscopists. It presents the most recent pondering and transparent guide at the ideas, that have been built-in with total sufferer care.

Written by way of the prime foreign names in endoscopy, the textual content has been expertly edited via Peter Cotton right into a succinct, instructive structure. offered in brief paragraphs dependent with headings, subheadings and bullet issues and richly illustrated all through with full-color images.

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Occlusion cholangiogram. Contrast is injected under pressure by inflating a balloon below the obstruction to fill the more proximal obstructed system. Pathological strictures Malignant CBD strictures appear as smooth or irregular narrowings with upstream dilatation (Fig. 10). These may be caused by cancers of the head of the pancreas (double duct stricture sign), gallbladder, or bile duct, or by lymphadenopathy at the liver hilum. Malignant bile duct strictures at the liver hilum are classified according to the Bismuth Classification: • Type I stricture is confined to the common hepatic duct with > 2 cm from the bifurcation.

Severe pancreatitis: irregularity with strictures and dilation of the main duct, with filling defects suggestive of stones or filling of cavities or cysts. There is no direct correlation between the radiological abnormalities and the functional loss in chronic pancreatitis because the pancreas has a good functional reserve. Leakage of contrast from a transected pancreatic duct with nonfilling of the upstream duct is diagnostic of traumatic pancreatitis. Cancer in the head of the pancreas may cause stricturing of the main pancreatic duct with uniform dilation of the side branches and the main duct upstream of the obstruction.

High-resolution digital fluoroscopy units produce better pictures but they are also much more expensive. A portable digital C-arm unit can be used but the resolution may be inferior to the full digital unit. It is preferable to use a machine with an under-couch X-ray tube. The X-ray machine should be capable of taking spot films. Digital units can store the images onto a computer for subsequent retrieval and review. Hard copies of selected images can be printed for reporting and filing. It is essential to know the magnification Fig.

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Advanced Digestive Endoscopy: ERCP by Peter B. Cotton

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