ERCP procedure or Endoscopic Retrograde Cholangio-Pancreatography is an assessment as well as a procedure meant for rectifying problems in bile and pancreatic ducts. This is considered to be a very critical and life saving procedure involving an endoscope. Examination of critical areas needs to be done and rectification has to be done immediately with planned procedural steps.
An ERCP procedure is recommended in order to diagnose the status of bile ducts and the pancreas and if there are problems discovered during diagnosis then they are treated as well. The procedure is appropriate in order to do evaluation of symptoms that are suggestive of certain diseases prevalent in these organs. It is also used as a method of reconfirmation of abnormal results generated from ultrasound, CT scan or imaging tests and blood tests. If CT scan reveals abnormal mass or stones in these organs then ERCP is recommended.
The procedure can even be performed before and after a gall bladder surgery to help in the conducted operation’s performance in overall. If there are stones or tumours of both cancerous and non cancerous nature then they can be removed with the help of ERCP procedure from bile ducts and pancreas. If there have been any complications noted during gall bladder surgery then those can also be diagnosed with the help of this. Patients having any pancreatic disease or suspected disorder for them the ERCP method can suggest the requirement of surgery and the type of surgery that may be best for the treatment. In some cases pancreatic stones can be addressed and removed with the help of ERCP procedure.
Causes of the problems are mainly because of narrowing or blockage of the bile ducts and pancreatic duct. Gall stones are formed and they get stuck to the common bile duct thus requiring surgical interventions. Gall stones are usually formed of cholesterol in maximum cases while for 20% cases it is a result of calcium and pigments like bilirubin giving rise to stones. Other causes can be imbalance of diet and irregular lifestyle giving rise to infection. Alcohol drinking and fatty food consumption results in acute and chronic pancreatitis.
The way to know that you may be a patient requiring ERCP is:
The procedure of ERCP enables the doctor or the surgeon to precisely examine the bile ducts and the pancreatic duct. In this procedure the endoscope which is a lighted tube and can be bent as well has a thickness of the index finger almost and it is inserted via the mouth of the patient and then it is made to access the stomach and the small intestine’s first part that is the duodenum. A small plastic tube named cannula is passed via the endoscope into the opening which is very small in size in the duodenum. The opening is called the ampulla. A contrasting substance or a dye is then injected and then X rays are carried out to start the study and find the status of the liver, pancreas and the ducts.
The surgery technique makes use of a combination of luminal endoscopy compiled with fluoroscopic technique of imaging for the purpose of diagnosing and performs treatment of conditions that are associated with pancreatobiliary system. A side viewing instrument named the duodenoscope is utilized in the endoscopic portion that is made to travel through the esophagus and reach the stomach to access the duodenum’s second portion which is the part of small intestine.
In ERCP Sphincterotomy both fluoroscope and endoscope are employed and deep cannulation is done of the bile duct which is then followed by the sphincter of Oddi’s severance with electrocautery (heating).
Coming back to conventional ERCP, next the duodenal pailla is identified with the scope in the position discussed above and further inspection is carried out to find any abnormalities. The duodenal papilla is like a structural protrusion of the ampulla of Vater or the hepatopancreatic ampulla into the duodenal lumen. The ventral pancreatic duct and the common bile duct have a convergence point and that is this ampulla. So this ampulla behaves like a channel for draining pancreatic secretions and bile into the duodenum.
If contrast is injected into the pancreatic duct or if the pancreatic duct gets cannulated for quite a number of times then a temporary pancreatic duct stent placement or rectally administered NSAIDS (diclofenac or indomethacin) has to be considered. This has to be considered aiming to reduce the post-ERCP pancreatitis (PEP) risks. For PEP prophylaxis these two prevention modalities have shown some promise. Somatostatin, gabexate, heparin, nitroglycerin, allopurinol, steroids, octreotide and many more pharmacological agents have been studied but the results found were pretty disheartening.
In the second portion or segment of the duodenum the minor duodenal papilla is also located and it behaves like an access point for the dorsal pancreatic duct. Dorsal pancreatic duct’s evaluation with ERCP is seldom performed and the ERCP indications are further discussed below:
With the side viewing endoscope the papilla is closely examined and then selective cannulation of ventral pancreatic duct or common bile duct is performed. Once the cannulation of the selected duct is performed then either pancreatogram of the pancreatic duct or cholngiogram of common bile duct is obtained fluoroscopically with the injection of a material that is radiopaque contrasting in nature is done into the duct. These days ERCP is considered by surgeons like a therapeutic surgery where abnormalities that are observed via a fluoroscope can be particularly addressed by the methods of specialized accessories that can be passed via the endoscope’s working channel.
This procedure is a very advanced process and as a result of this serious complications tend to occur at a higher frequency than many other endoscopic processes. As per that special training and specialized devices and equipments are employed and for appropriate indications only this procedure is employed.
Indications that have been recorded for biliary diseases are given below:
Assessment of biliary obstruction and its treatment secondary to choledocholithiasis- if ascending cholangitis, worsening pancreatitis or worsening jaundice which are persistent are present then Precholecystectomy ERCP may be indicated.
Pancreatic malignancies can be diagnosed and the indications are:
There are also indications for ampullary diseases like
If a patient has the possibilities of developing post ERCP pancreatitis, then the process of diagnosis grows apparent within some hours after the procedure. The patient shall experience severe pain in abdomen back pain and nauseated feelings may be accompanied with vomiting sensation) and some amount of fever is also common. But then the observation period does not stretch beyond an hour after the ERCP procedure and is not enough time for checking for post ERCP Pancreatitis. For evolving post ERCP pancreatitis a two hour serum or urinary amylase level (>1000IU/L) is highly predictive if the patient can be kept under observation for a longer duration of time.
Another kind of procedure closely related to ERCP is the employment of miniature endoscopes that can be inserted via the operating channel of the duodenoscope. These can be directly inserted into the pancreatic or the bile duct. The interior side of the duct can be visualized and accordingly biopsies can be taken. There remain other possibilities for therapeutic interventions.
If in the common bile duct the bile duct stones are seen then the opening of the papilla will be made wider with the help of electrocautery or heating and then the stones are removed. For removal of stones sometimes a basket may be employed. If the narrowing of the bile duct is seen in the X-ray images then a small wire mesh or plastic tube which is a stent can be inserted to facilitate the bypassing of the blockage and allow the bile to move to the duodenum. Very mild pain after ERCP stent placement is felt.
ERCP complication chances are vastly reduced when performed by expert surgeons but still there persists some amount of complications like:
If by accident food or fluid is inhaled in the lungs then that can be a complication but it rarely occurs in patients who do not drink and eat several hours prior before the ERCP test.
As the sedative medications start wearing off the patient will be observed for further complications. The medicines administered causes drowsiness and there are difficulties observed in concentration so a patient will be advised to stay away from work.
The discomfort as most patients have expressed is a feeling of bloating which is a result of the introduction of air in the system during the time of examination but this problems can be quickly fixed. Some patients experience a throat sore which is very mild usually.
Most patient are in a condition to drink clear liquid after the test and in some scenario blood tests have to be conducted right after the ERCP procedure. If biopsy samples have been taken then they are required to be sent to the lab for further analysis right after the procedure.
Some amount of fatigue is very common during the recovery period and for abnormal temperatures observed one should immediately inform the clinical team to check for the conditions.
ERCP (Diagnostic) package cost in Lithuania has different inclusions and exclusions. Some of the best hospitals for ERCP (Diagnostic) offer a comprehensive package that covers the end-to-end expenses related to investigations and treatment of the patient. The comprehensive ERCP (Diagnostic) package cost includes the cost of investigations, surgery, medicines and consumables. A prolonged hospital stay due to delayed recovery, new diagnosis and complications after surgery may increase the cost of ERCP (Diagnostic) in Lithuania.
After ERCP (Diagnostic) in Lithuania, the patient is supposed to stay in guest house for another 3 days. During this time, the patient undergoes medical tests and consultations. this is to ensure that the treatment was successful and the patient us safe to return.
There are certain expenses additional to the ERCP (Diagnostic) cost that the patient may have to pay for. These are the chanrges for daily meals and hotel stay outside the hospital. The extra charges may start from USD 50 per person.
ERCP (Diagnostic) in Lithuania is offered in almost all metropolitan cities, including the following:
The average duration of stay at the hospital after ERCP (Diagnostic) is about 1 day for proper care and monitoring. The patient is subjected to several biochemistry and radiological scans to see that everything is okay and the recovery is on track. After making sure that patient is clinically stable, discharge is planned.
There are more than 2 hospitals that offer ERCP (Diagnostic) in Lithuania. Such clinics have the required infrastructure and a dedicated unit where patients can be treated. Also, these hospitals follow the necessary guidelines as required by the medical associations for the treatment of ERCP (Diagnostic) patients.
Some of the most sought after doctors for ERCP (Diagnostic) in Lithuania are:
An international organisation which is respected all over the world as an accrediting body, Joint Commission International has accredited several hospitals in Lithuania as well. The hospitals in Lithuania who are implementing a 360* experience for the patients and are combining it with the best healthcare are achieving the JCI accredition status. JCI certified those healthcare organisations in Lithuania that meet its safety and quality standards. The Joint Commission International or JCI accreditation signals good service quality and the healthcare organisations that get the certification are guided by JCI towards continued performance improvement.
We bring to you some good multispecialty hospitals in Lithuania: .
It speaks to the overall development of the multidisciplinary hospitals in Lithuania that it has a wide scope in terms of the kinds of procedures that can be performed here. It is the skilled team of healthcare experts in the multidisciplinary hospitals in Lithuania that provide the strength to any patient that all their healthcare concerns will be resolved. In the multidisciplinary hospitals in Lithuania, you can be assured of the implementation of advanced technologies at affordable costs to give the best medical treatment.
Do opt for healthcare in Lithuania as you will get quality healthcare in this country than anywhere else. The dedication of healthcare professionals in Lithuania is to present a complete healthcare experience to the patients which is based on the qualities of efficiency and safety. The healthcare in Lithuania is patient centric and focused on providing the patients with the best healthcare solutions irrespective of self benefit. If you are looking to get good tertiary care based on good medical research, then Lithuania is the right destination to get healthcare from.
We can safely say that healthcare in Lithuania is comprised of physicians who are implementing healthcare options that not only imply increased success rates but decreased complications. The specialists in the hospitals in Lithuania are not only well educated and experienced but have gained prominence as specialists in their fields. In Lithuania, the doctors are doing great work in working to get international patients better and have gained proficiency in their work over a period of time. The doctors in Lithuania are well versed with application of latest technologies and have used them to treat an increasing number of patients regularly.
The essential documents that you need to carry with you on your medical travel to Lithuania are listed below:
As a medical traveller to Lithuania, you will find the travel and transfer process fairly easy, seamless and effortless considering your travel documents are well in place. When traveling to Lithuania, please ensure that your travel, treatment and accommodation related documents are with you. Your travel preparation to Lithuania begins when your checklist is made with which you can tally the documents you plan to carry.
There are many popular procedures that are routinely performed in Lithuania such as:
Vitrectomy is one of the many Eye procedures that are a draw for the medical tourists in LithuaniaMedical travellers to Lithuania are coming to the country for many popular procedures one of which is the Opthalmological procedures like Vitrectomy. In Lithuania, people are coming from several countries to get Orthopaedic procedures done, Knee Replacement and Hip Replacement are two such procedures. The hospitals in Lithuania are enabling procedures such as sclerotherapy very well for treatment of varicose veins, spider veins or related symptoms.
Protect yourself from potential health disasters through vaccinations considered mandatory by WHO or World Health Organisation and CDC or Centers for Disease Control and Prevention. The recommended vaccinations before your travel to Lithuania are as follows:
It is essential that you keep into account the right age and prior and emergent medical conditions before deciding on your recommended vaccinations before your medical travel to Lithuania. Do find outlined the vaccinations that you must be updated with at all times, even prior to your medical travel to Lithuania.
In Lithuania it is the three cities of Vilnius, Kaunas and Klaipeda which are the important medical tourism destinations. Lithuania is considered one among the top ten medical tourism destinations in the world as it brings in the best in health service quality at low prices. The well qualified and hospitable healthcare and tourism personnel in Lithuania are adding to the weight age of Lithuania as a medical tourism destination. The post treatment experience in Lithuania is made complete with the rehabilitation centers and medical spas.
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