Posted: Monday, March 13, 2023

How Therapeutic Endoscopy Can Help

Therapeutic endoscopy with ERCP (endoscopic retrograde cholangiopancreatography) is used to diagnose and treat conditions in the liver, gallbladder, bile ducts and pancreas. Combining X-ray with an endoscope, the ERCP is a thin, flexible tube with a tiny camera on the end that can be moved down the throat, through the digestive tract and into the small intestine. Dye can be injected for imaging tests and, if needed, stones can be removed, stents can be placed or further diagnostic assessments with biopsies can be performed. The most common reasons for ERCP are jaundice, stones in the bile or pancreas duct, or lesions or tumors in the pancreas, gallbladder or liver.

With ERCP, Blount Memorial board-certified and fellowship-trained gastroenterologist Dr. Frank Wright can use a special scope to visualize and treat certain conditions. “The Spyglass™ Choledochosope at Blount Memorial allows the gastroenterologist to remove impacted gallstones from the bile duct with lithotripsy – the use of ultrasound shockwaves to break the stones into small particles that can be passed out of the body. This also helps us obtain direct tissue biopsies of bile duct and pancreatic tumors, so it’s a great advantage to our patients who are undergoing the ERCP procedure, and it’s something not every gastroenterologist in the area has at the ready,” Wright said. “It’s not uncommon for stones to leave the gallbladder, go into the bile duct and cause an obstruction. So, we go in and open the end of the duct to allow that stone to pass through,” Wright added. 

Before the ERCP procedure, your doctor will ask you to stop eating at a certain time, and to stop certain medications ahead of time. You may stay overnight and will need someone to drive you home, as well. Results usually are available the day of the procedure, but if a biopsy was taken, it may take a few days to return a result. The most common complication is pancreatitis due to irritation from the dye used. If other procedures are performed, such as removing stones, there is a small risk of bleeding or infection, but these complications are rare.

“I really believe in talking to patients. I spend time with them and try to explain everything in detail so they are well prepared and comfortable with the procedure. I’m a local guy and I want to take care of my community the best I can,” Wright said. “The good thing about our group is that, in addition to the general gastroenterological offerings, we also have therapeutic endoscopies and EUS (endoscopic ultrasound) – most of the hospitals don’t have all that, but we do. It’s really a phenomenally put together group that we have here at Blount Memorial Physicians Group – Gastroenterology,” he added.

For more information about ERCP, or to schedule an appointment with Dr. Wright, call Blount Memorial Physicians Group – Gastroenterology at 865-980-5060.

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