ERCP (Diagnostic) cost in Switzerland

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About the ERCP (Diagnostic)

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.

Who needs an ERCP?

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 ERCP

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.

Symptoms of ERCP

The way to know that you may be a patient requiring ERCP is:

  • Abdominal cramps
  • Fever and Nausea
  • Vomiting tendency with occasional bleeding
  • Irritation felt in the stomach
  • General fatigue experienced

 

What is ERCP?

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.

How is ERCP (Diagnostic) performed?

ERCP surgery

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.

  • With intraoperative cholnagiography or common bile duct exploration without the extraction of stone, treatment of choledocholithiasis is identified during cholcystectomy.
  • Bile duct stricture assessment and subsequent treatment- bening and malignat strictures and and congenital abnormalities of the bile duct.
  • Postoperative complications
  • Postoperative biliary leaks’ treatment and assessment
  • Sphincter of Oddi dysfunction of selected patients, their assessment with treatment with little benefit in modified Milwaukee classification type III patients
  • For recurrent and acute pancreatitis for which the underlying cause is unknown in patients; their treatment followed after assessment
  • Symptomatic strictures associated with chronic pancreatitis; assessment and treatment
  • Symptomatic pancreatic duct stones; their treatment after assessment
  • Symptomatic duct stones’ assessment and treatment

Pancreatic malignancies can be diagnosed and the indications are:

  • Biopsy and brushing of the bile duct
  • Pancreatoscopy
  • Intraductal ultrasonography

There are also indications for ampullary diseases like

  • Assessment of ampullary malignancy
  • Ampullary adenomas’ assessment and treatment

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 Complications

ERCP complication chances are vastly reduced when performed by expert surgeons but still there persists some amount of complications like:

  • Pancreatitis or inflammation of the pancreas is the commonly occurring complication found in 3 to 5% of the patients undergoing the surgery. Usually it is mild causing nausea and pain in the abdomen region which can be treated during the stay in hospital. It is very rare that pancreatitis grows severe during ERCP.
  • A cut into the ampulla becomes necessary by the endoscopist and as soon as that happen some amount of bleeding can occur at the site of the cut ampulla. However it is minimal and stops in sometime all by itself or it can be controlled during the surgery.
  • A tear or hole in the intestine can happen accidentally due to the insertion of the scope or any other instrument. This happens rarely but when it occurs it is a serious condition requiring immediate surgical intervention.
  • Infection or cholangitis is also very rare in the bile ducts but if it occurs among patients with preexisting conditions then treatment has to be started where antibiotics need to be administered and drainage of excess fluids need to be carried out.


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.

Recovery from ERCP (Diagnostic)

Aftercare and recovery

 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.

Patient Stories

Frequently Asked Questions

What are the factors affecting the cost of ERCP (Diagnostic) in Switzerland?

ERCP (Diagnostic) package cost in Switzerland 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 treatment cost usually includes the expenses related to hospitalization, surgery, nursing, medicines, and anesthesia. Extended hospital stay, complications after the surgery or new diagnosis may affect the overall cost of ERCP (Diagnostic) in Switzerland.

Which are some of the best hospitals in Switzerland for ERCP (Diagnostic)t?

There are many hospitals that perform ERCP (Diagnostic) in Switzerland. Some of the best hospitals for ERCP (Diagnostic) in Switzerland include the following:

  1. Paracelsus Clinic
How many days does it take to recover post ERCP (Diagnostic) in Switzerland?

Upon discharge from the hospital after ERCP (Diagnostic) in Switzerland, the patients are advised to stay for about 3 days for recovery. This is important to ensure that the surgery was successful. During this time, control and follow-up tests take place to check for medical fitness.

Which are some of the other popular destinations for ERCP (Diagnostic)?

Switzerland is undoubtedly one of the best countries for ERCP (Diagnostic) in the world. It offers the best medical expertise and good patient experience at an affordable cost. Some of the other popular destinations for ERCP (Diagnostic) include the following:

CountryCost
IndiaUSD 800
SingaporeUSD 14000
TurkeyUSD 4500
How much are the other expenses in Switzerland apart from the cost of ERCP (Diagnostic)?

Apart from the ERCP (Diagnostic) cost, the patient may have to pay for additional daily expenses such as for guest house after discharge and meals. The per day extra expenses in Switzerland per person are about USD 50 per person.

Which are the best cities in Switzerland for ERCP (Diagnostic) Procedure?

ERCP (Diagnostic) in Switzerland is offered in almost all metropolitan cities, including the following:

  1. Geneva
  2. Lustmuhle
  3. Basel
How many days does one have to spend in the hospital for ERCP (Diagnostic) in Switzerland?

After ERCP (Diagnostic), the patient is supposed to stay for about 1 day in the hospital for recovery and monitoring. The doctors team review the patient's recovery during this time with the help of blood tests and imaging scans. Once they feel that everything is on track, the patient is discharged.

How many hospitals offer ERCP (Diagnostic) in Switzerland?

There are more than 1 hospitals that offer ERCP (Diagnostic) in Switzerland. Such hospitals 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.

FAQ's Related to Switzerland

Which are the popular multispecialty hospital groups in Switzerland?

There are many top-class multispecialty hospitals in Switzerland, such as:

  1. Paracelsus Clinic, Lustmuhle;
  2. Geneva Women Care, Geneva;
  3. Universitatsspital Basel, Basel;
  4. Klinik Hirslanden Zürich, Zurich;
  5. Lindenhofspital Bern, Bern;
  6. Hirslanden Klinik Aarau, Aarau

With more than 500 hospitals, the country has some of the biggest private hospitals in the world. More than 12 hospitals are JCI accredited and they strictly follow international standards. A rising number of hospitals have developed centers of competence for outpatient diagnostic and therapy. Swiss hospitals deliver up to 70 percent of all out-patient services in a given region. Backed by state-of-art infrastructure and advanced medical technology, the world-class multispecialty hospitals in Switzerland are able to provide unmatched treatment with high precision and accuracy.

What healthcare accreditation standards are followed in Switzerland?

In Switzerland, healthcare providers are obliged by law to sign contracts on quality of care based on international standards. International Standards Organization serves as a model of healthcare standards in Switzerland. Healthcare accreditations are given according to the standard EN 45001 which acts as a benchmark for the quality of test results evaluated as per the set values and requirements, thus contributing to the evaluation of the technical competence of a provider. Healthcare standards help hospitals to evaluate, control, and improve the standards of quality healthcare.

Why should I opt for healthcare in Switzerland?

A few reasons why Switzerland is leading the way in medical tourism are traditional values of quality, precision, cleanliness, research-focus, and highly qualified experienced staff. Switzerland has some of the best infrastructure available, which naturally reflects in its medical tourism sector. Travelers have flocked to the country to take the advantage of healing waters. Their exceptional research institutes offer medical care of the highest quality. Switzerland has received worldwide recognition for its contribution to medical innovation and new treatments. Several renowned research institutes have come up with medical breakthroughs and new treatments.The Swiss are well known for their excellence in medical innovation and new treatments. Several world-famous research institutes have contributed to medical breakthroughs and new treatments. Some other reasons why Switzerland is preferred for medical tourism are quality and safe treatments, high level of privacy, and a wide range of treatment specialties.

Do hospitals in Switzerland accept health insurance?

Most of the hospitals in Switzerland accept health insurance. You need to check with your insurance company in your country whether the procedure you want to avail is covered at the hospital in the country. If it is an approved insurance provider, the hospital will request the GOP (Guarantee of Payment) from the insurance directly to commence your treatment cashless. It is important to note that there are many things that are not covered under insurance like cosmetic surgery, pregnancy and abortion, and diagnostic tests. If your insurance plan is not approved in Switzerland, you will have to pay for the treatment and later claim for reimbursement once you return to your country.

What are the popular procedures available in Switzerland?

Switzerland has received worldwide recognition for reporting high success rates in the following procedures.

  1. Cosmetic surgery
  2. IVF treatment
  3. Neurosurgery
  4. Obesity surgery
  5. Orthopaedic surgery

These procedures in Switzerland are performed with high success rates because of high-standard clinics available, state-of-the-art technology, and well-trained doctors. Switzerland has gained immense popularity for its excellence in cosmetic surgery and presence of medical health spas which have also made it a preferred spot for medical tourists. The credit for the high success rate of IVF mainly goes to Swiss fertility experts who have been regarded as ‘artists’ due to their skills in fertility treatment and their commitment towards personalized care.

Which are the most popular cities in Switzerland for medical treatment?

The top-ranked cities that are most preferred by medical tourists in Switzerland are Basel, Geneva, Lausanne, Lugano, Zurich, Lucerne, Bern. Backed by world-class hospitals with highly professional and talented hospitals and modern infrastructure, Switzerland delivers unmatched treatment. These cities have modern infrastructure, world-class hospitals, and highly trained doctors which contribute to providing quality treatment. These cities have become leading medical tourism destinations in Switzerland due to many other factors, such as a large pool of world-class hospitals, rich heritage, scenic value, availability of translators, and safety of tourists.

Is it mandatory to take vaccinations before going to Switzerland?

The vaccines recommended by WHO and CDC are:

  1. Hepatitis A
  2. Hepatitis B
  3. Rabies
  4. Meningitis
  5. Polio
  6. Measles
  7. Mumps and rubella (MMR)
  8. Tdap (tetanus, diphtheria and pertussis)
  9. Chickenpox
  10. Shingles
  11. Pneumonia
  12. Influenza.

Always have MMR and other routine vaccinations because some regions of Switzerland have periodic disease outbreaks. Your vaccination and the dosage will depend on several factors, including immunization history, traveler's age, and current medical conditions. Before traveling to Switzerland, it is suggested to get pre-exposure vaccination against rabies and yellow fever.

What is the process for obtaining medical visa in Switzerland?

Schengen Visa allows a person to travel to Switzerland to seek medical treatment. You can stay for a maximum of 90 days in the country if you have this visa. If your treatment is foreseen to last longer, you should apply for a National Visa for Medical Treatment. Here is a list of documents that you will require for applying for a medical visa:

  1. Full return flight reservation
  2. Proof of stay in Switzerland
  3. Signed official medical letter from medical institution
  4. Signed medical letter from a recognized local practitioner
  5. Passport
  6. Passport-sized photographs
  7. Online Application form

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