Cholangioscopy

What is Cholangioscopy?
Cholangioscopy is primarily used for the treatment of difficult bile duct stones and for the evaluation of biliary strictures.

Types of Cholangioscopy Procedures

  • ERCP
    An endoscopic retrograde cholangiopancreatography (ERCP) is used to treat and diagnose problems in the liver, gallbladder, bile ducts, and pancreas. These problems include blockage of the bile duct, the pancreatic duct, a leaky duct or irritation of the pancreas or liver. ERCP combines the use of X-rays, contrast dyes, and an endoscope.

  • Enteral stents
    Stents may be placed within your stomach, small bowel, and/or colon to treat an obstruction within your gastrointestinal tract.

  • Small bowel Enteroscopy
    In small-bowel enteroscopy, your doctor inserts a longer scope into more distant parts of the small intestine.
    • Single balloon Enteroscopy
      Single balloon enteroscopy is an endoscopic way to evaluate the small intestine. There are two approaches to this procedure, the anterograde and retrograde enteroscopy.  In the anterograde approach, the enteroscope is initially passed through the mouth and into the esophagus, similar to a standard endoscopy.  Then, the endoscope is pushed maximally into the small bowel. There is an inflated balloon attached to the enteroscope that allows for pushing of the tube into the small intestine.  In the retrograde approach, the scope is inserted through the rectum and advanced into the small intestine.

    • Double balloon Enteroscopy
      Double-balloon enteroscopy involves the use of a balloon at the end of a special endoscope and a tube which fits over the endoscope, and which is also fitted with a balloon. Both the scope and overtube are inserted through the mouth and passed into the small bowel. Following this, the endoscope is advanced a small distance in front of the overtube and the balloon at the end is inflated. The small bowel is then pleated backwards like an accordion to the overtube. The overtube balloon is then deployed, and the balloon is deflated. The process is then continued until very distant parts of the small bowel are seen. This technique can be used to treat otherwise inaccessible parts of the small bowel.

About the Procedure
A physician may choose to perform a cholangioscopy in the event that x-ray imaging from an ERCP is insufficient to make an adequate diagnosis, or therapeutic intervention requires direct visualization. Using an endoscope called the SpyGlass Probe, your physician will be able to visualize and examine the biliary (pancreas) and hepatic (liver) ducts.

Preparation
You may not each or drink 8-12 hours prior to the procedure.  If you are on blood thinning medication, ask your provider if you need to stop them prior to the procedure.

During the procedure
You will be asked to change into a gown before the procedure. You will be given a sedative by the anesthesiologist who will be present to monitor your vital signs during the examination. You will not experience any sensation of gagging or choking. A mouthpiece will be placed between your teeth to protect your mouth.  The endoscope does not interfere with your breathing.

After the Procedure
After the procedure, you will remain in a recovery room until most of the effect of the sedative has worn off. Because of sedation used during the procedure, you'll need to make plans to have someone take you home.

Common Side Effects

  • Reactions to the sedative. The drugs used to sedate you may continue to cause drowsiness and may cause nausea and vomiting.
  • Sore throat. If the endoscope was guided down your esophagus, you may experience a sore throat.  Lozenges help to sooth the throat.
  • Gas or cramps. A small amount of air may have been pumped into your digestive system to make it more accessible. This can result in gas, bloating or cramps after the procedure.

Possible complications:
Common complications are bleeding, perforation (or tear), and stricture (narrowing of intestine).

Endoscopic retrograde cholangiopancreatography (ERCP) is used to treat and diagnose problems in the liver, gallbladder, bile ducts, and pancreas. ERCP uses endoscopy and x-rays. An endoscopy is the use of a special scope with a camera to view your throat, stomach, and upper intestine.

 

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