Magnetic Resonance Cholangiopancreatography (MRCP) Versus Endoscopic Retrograde Cholangiopancreatography (ERCP) for the Management of Patients with Suspected Biliary Obstruction


Book Description

"Aims. To assess the real-life effectiveness and costs of MRCP versus ERCP in a planned interim analysis of a randomized clinical trial, in intermediate risk patients. To assist in the decision regarding study continuation versus termination." --







Magnetic Resonance Cholangiopancreatography (MRCP)


Book Description

This book, based on the experience of a single large referral center, presents the characteristic findings obtained when using MR imaging and MR cholangiopancreatography (MRCP) to image the biliary tree and pancreatic ducts in a variety of disease settings. An introductory chapter is devoted to technical considerations, anatomy, and developmental anomalies. Subsequent chapters then present in detail the MR imaging and MRCP findings observed in choledocholithiasis, inflammatory and neoplastic disorders of the bile ducts, acute and chronic pancreatitis (according to etiology), and different pancreatic neoplasms. Dynamic MRCP with secretin stimulation is also illustrated, documenting both normal and abnormal responses of the pancreatic duct system to secretin. Readers will find this book to be an excellent aid to the interpretation of MR imaging and MRCP findings in patients with biliary and pancreatic disease. ​




ERCP and EUS


Book Description

This text provides a comprehensive review of ERCP and EUS and the clinical conditions for which they are employed. Presented in a case-based format with accompanying videos, it will serve as a valuable practical clinical resource for gastroenterologists with an interest in ERCP and EUS. The text highlights major techniques involved in ERCP, reviews complications and recent data on preventing post-ERCP pancreatitis, and discusses important issues in training in ERCP including use of endoscopic simulators and assessment of competency as emphasized in the new ACGME guidelines. For biliary diseases, new techniques for managing biliary stones, novel technologies for diagnosing indeterminate biliary strictures, and new devices for treating benign and malignant strictures are also highlighted. For pancreatic diseases, advances in minimally invasive endoscopic techniques for pancreatic stones and strictures, and management of the complications of pancreatitis are reviewed. Furthermore, ERCP is not limited by age, pregnancy or history of abdominal surgeries and special considerations particular to these patient populations are also discussed. The EUS chapters review the breadth of equipment available for performing EUS and EUS-FNA, detail the technique of performing EUS-FNA, and explore pertinent issues with training and assessing competency analogous to ERCP training. Valuable insights on the basics of cytopathology relevant to the endosonographer are summarized. The classic indication for EUS of staging luminal cancers is examined in detail while pancreaticobiliary indications are discussed highlighting newer adjunctive technologies including elastography and contrast-enhanced EUS. Although in its infancy, the brave new world of therapeutic EUS is explored with a focus on endoscopic necrosectomy, EUS-guided biliary and pancreatic access as well as the exciting possibilities of EUS-guided radiofrequency ablation and injection of anti-tumor agents. ERCP and EUS: A Case Based Approach will serve as a very useful resource for physicians who perform or refer patients for ERCP and EUS. It provides a concise yet comprehensive summary of the current status of ERCP and EUS that will help guide patient management and stimulate clinical research. ​




MRCP


Book Description

Magnetic resonance cholangiopancreatography (MRCP) is a newly developed noninvasive diagnostic technique for sectional and projectional imaging of the pancreatobiliary tree. Requiring no contrast materials, MRCP provides high-quality 2-D and 3-D images that facilitate early diagnosis and treatment of pancreatobiliary diseases. The authors draw upon their experience of more than 3000 MRCP studies as they illustrate the usefulness of this important new diagnostic modality. This volume is a valuable resource with state-of-the-art information for practitioners, researchers, and others in the fields of gastroenterology, radiology, and surgery.




ERCP


Book Description

Provides the comprehensive knowledge required to perform ERCP safely and effectively Authored by the very best in the field, this “how-to” guide to mastering the crucial yet complex gastrointestinal procedure called endoscopic retrograde cholangiopancreatography (ERCP) covers the entire range of both standard and advanced techniques, using a highly practical approach. It also places a strong emphasis on patient education, safety, and minimizing risks, offering “tips and tricks” and key points throughout to aid rapid understanding. The book is filled with over 250 illustrations Covering ERCP preparation, techniques, clinical applications, and quality and safety, ERCP: The Fundamentals, 3rd Edition begins with chapters on “getting prepared,” including training and competence; facilities and equipment; risk assessment and reduction; sedation, anesthesia, and medications. It then covers “what can be done,” describing standard devices and techniques; intraductal therapies; ampullectomy; and reporting and documentation. Next it has chapters on “what should be done,” clinical applications of ERCP in acute cholangitis; peri-cholecystectomy; difficult bile duct stones; biliary pain; and numerous forms of pancreatitis. The book finishes with coverage of adverse events and how to ensure competent practice. Teaches all of the standard and advanced ERCP techniques Focuses on patient safety/comfort throughout Brilliantly-illustrated with endoscopic, EUS and radiologic images, and anatomical drawings Offers a step-by-step, practical approach to ERCP—highlighting potential technical and anatomical hazards Packed with tips and tricks boxes and key points boxes to assist comprehension 20 high-definition videos of ERCP performed by the experts, perfect to improve clinical technique Full reference to the very latest ASGE, ACG, ASG and UEGW guidelines throughout Brought to you by world pioneers in endoscopy, ERCP: The Fundamentals, 3rd Edition is an essential purchase for gastroenterologists and endoscopists of all levels.




A Systematic Review and Economic Evaluation of Magnetic Resonance Cholangiopancreatography Compared with Diagnostic Endoscopic Retrograde Cholangiopancreatography


Book Description

The aim of this review is to compare the clinical and cost-effectiveness of magnetic resonance cholangiopancreatography (MRCP) with diagnostic endoscopic retrograde cholangiopancreatography (ERCP) for the investigation of biliary obstruction.







Clinical Pancreatology for Practising Gastroenterologists and Surgeons


Book Description

Clinical Pancreatology Since the book Clinical Pancreatology for Practising Gastroenterologists and Surgeons was first published sixteen years ago, the knowledge and clinical management of pancreatic diseases have developed markedly. Thanks to the development of the translational research and the from bench to bedside concept, much progress from the lab has been applied to clinical practice. In addition, several highly relevant clinical trials published over the last years have resulted in the update and optimisation of clinical guidelines. A new and validated classification of severity and complications of acute pancreatitis is firmly rooted in clinical practice and has been the basis for the development of minimally invasive approaches to pancreatic necrosis. The etiopathogenic knowledge of chronic pancreatitis and other pancreatopaties, like that associated with diabetes mellitus, has developed significantly. Especially important has been the development of the field of cystic pancreatic tumours, which has been reflected in the publication of several guidelines and consensus reports over the last few years. Most research efforts have focused on pancreatic cancer, which have led and will further lead to a significant increase in the therapeutic armamentarium against this devastating disease. Finally, many newly published studies have changed the concept, causes, clinical relevance, diagnosis and treatment of exocrine pancreatic insufficiency. This new edition of Clinical Pancreatology for Practising Gastroenterologists and Surgeons has enjoyed the collaboration of the world’s leading experts in each of the areas of clinical pancreatology with the aim of facilitating gastroenterologists, surgeons, oncologists, internists, nutritionists, diabetologists, paediatricians, radiologists, pathologists and other specialists in their decision making when facing patients with pancreatic diseases in their daily clinical practice. All in all, this book supplies an indispensable update of the relevant aspects of clinical pancreatology.




The SAGES Manual of Biliary Surgery


Book Description

Although benign biliary disease is an area in which many surgeons have experience, there are many nuances to providing the highest quality of surgical care. The biliary anatomy is unique but presents with anatomical variances and can be distorted by benign pathology. Biliary surgery has been one of the areas where minimally invasive techniques were first applied in the late 1980s. However, surgical technique has continued to evolve due to acquisition of advanced minimal surgical skills and improvement in surgical technology. The expertise, sage, and knowledge of the members of the Society of American Gastrointestinal and Endoscopic Surgery (SAGES) have prioritized the creation of this manual on modern biliary surgery. This manual will provide the standard for the current state of biliary surgery in the 21st century. The SAGES Manual of Biliary Surgery will align with the new SAGES University Masters program. The Manual supplements the Masters Program Biliary Surgery Pathway. Its goal is to help the surgeon progress from the competent to the proficient and finally to the mastery level. Both for the surgical trainee and senior surgeon, this guidebook will also give insight into modern evaluation and management. The highlights will emphasize what is both feasible and safe from a minimally invasive approach in biliary surgery. The concept of Safe Cholecystectomy will be defined and expounded on in detail. The difficult cholecystectomy will be given ample coverage to include management of intraoperative bile duct injury, indications and techniques of subtotal cholecystectomy, and special attention to intraoperative diagnostic imaging that serve as adjuncts, including cholangiograpy, ultrasound, as well as indocyanine green biliary fluorescence. We will review the updated international Tokyo guidelines for acute cholecystitis. Furthermore, the evolution of treatment of choledocohlithiasis has evolved the most in recent years, and thus requires an extensive discussion of the non-operative and operative management of bile duct stones. This text will serve as an important contribution to the medical literature sponsored by SAGES, an international leading authority in gastrointestinal surgery with a keen interest in safe and proficient biliary surgery. Leaders in the field of biliary surgery will impart their insight and considerable experience in the chapters planned for this manual. The intent for this manual is to be the cited resource for high quality and applicable knowledge for the treatment of benign biliary disease.