What is the difference between ERCP and EUS?

What is the difference between ERCP and EUS?; Endoscopic ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography (ERCP) are both procedures that are used to examine the gastrointestinal (GI) tract. They are both used to examine organs in the GI tract such as the liver, gall bladder, and pancreas. They both involve the use of an endoscope but they are not entirely the same.

The major difference between EUS and ERCP is that endoscopic ultrasound uses high-frequency sound waves to create images while ERCP uses a video camera and x-ray imaging to create images.

What is Endoscopic Ultrasound?

Endoscopic ultrasound (EUS) is a minimally invasive procedure used to assess and examine the gastrointestinal or digestive tract. It can also be used to assess lung diseases.

It involves the use of a special endoscope that uses high-frequency sound waves to produce detailed images of the lining and walls of the digestive tract, chest, and nearby organs such as the pancreas, liver, and lymph nodes.

EUS is used to find the cause of abdominal or chest pain, to ascertain the severity of diseases in the digestive tract and lungs, and to evaluate results from imaging tests such as a CT scan or MRI.

Doctors may use EUS during the evaluation of:

• Cancer of the colon, esophagus, lung, pancreas, or stomach
• Ampullary and rectal cancers
• Lymphoma
• Barrett’s esophagus
• Neuroendocrine tumors
• Pancreatitis and pancreatic cysts
• Bile duct stones
• Sarcoidosis

EUS can help:

• Assess how deep a tumor has penetrated the abdominal wall in esophageal, gastric, rectal, pancreatic and lung cancers
• Determine the severity or stage of cancer
• Provide useful information about non-small cell lung cancer cells
• Evaluate abnormal findings from imaging tests
• Guide drainage of pseudocysts and other abnormal accumulation of fluid in the abdomen
• With delivering the right medication for the treatment of the pancreas, liver and other organs

Preparation for a EUS

• You will be likely asked not to eat anything for at least 6 hours before undergoing EUS. This is to make sure your stomach is empty before the procedure.
• You may be asked to take a laxative or have an enema before the procedure if the EUS is being done in the rectal area
• You will be asked to stop taking certain medications, such as blood thinners. Inform your doctor about all the medications you’re currently taking.
• Your doctor will provide you with specific instructions if you have certain conditions such as diabetes or high blood pressure.
• Arrange for someone to drive you back home because you won’t be able to drive home by yourself.

How is a EUS procedure done?

You will be sedated or given a local anesthetic to help you relax throughout the procedure.

You will be asked to lie down on an examination table. Your doctor will then pass a thin, flexible tube (endoscope) through your mouth into your digestive tract. A small ultrasound device (transducer) will be placed in the tube. The transducer produces sound waves that create a detailed image of the surrounding tissue and lymph nodes in your chest.

After the procedure is completed and image taken, the endoscope is then gradually withdrawn.

What is ERCP?

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines the use of gastrointestinal (GI) endoscopy and x-rays (fluoroscopy) to diagnose and treat problems of the bile and pancreatic ducts.

ERCP allows your doctor to see the pancreatic and bile ducts. The pancreatic and bile ducts carry digestive juices from your liver and pancreas to the intestines.

Doctors perform ERCP when your bile or pancreatic ducts have become narrowed or blocked as a result of;

• Gallstones that form in your gallbladder and become stuck in your bile duct
• Infection
• Acute pancreatitis
• Chronic pancreatitis
• Trauma in your bile or pancreatic ducts
• Surgical complications in your bile or pancreatic ducts
• Pancreatic pseudocysts
• Tumors or cancers of the bile ducts
• Tumors or cancers of the pancreas

Preparations for ERCP

The preparations for ERCP are quite similar to that of EUS.

• You will be asked to stop taking blood thinners
• You may be asked not to eat for about 8 hours before the procedure
• Inform your doctor about all the medications you’re currently taking
• Your doctor will provide you with other specific instructions
• Arrange for someone that will drive you back home

How is ERCP done?

You will be given sedatives or a local anesthetic to make you feel more relaxed and comfortable throughout the procedure. Sedatives may be given through an intravenous (IV) line.

You’ll be asked to lie on an examination table and your doctor will then carefully pass an endoscope through your mouth down your esophagus into your stomach, and into your duodenum. A small camera is attached to the tip of the endoscope. The camera sends video image of the inside of your stomach and duodenum to a monitor. Your doctor pumps air through the endoscope inside your stomach and duodenum to make them expand and more clearer to see. Your doctor is able to view the inside of your stomach and duodenum on the monitor.

Your doctor is able to locate the opening where the bile and pancreatic ducts empty into the duodenum.

Your doctor then slides a thinner, flexible tube called a catheter through the endoscope into the ducts. A contrast dye is then injected into the ducts through the catheter to make the ducts more visible and clearer on x-rays

Your doctor will then use a type of x-ray imaging, called fluoroscopy, to examine the ducts and look for the areas that are narrowed or blocked

Your doctor may then pass tiny tools through the endoscope to open the blocked or narrowed ducts, break up or remove stones, perform a biopsy or remove tumors in the ducts.

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