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Advanced Endoscopy - ERCP and EUS service

Holmesglen Private Hospital is proud to offer two new services to the community. Endoscopic Retrograde Cholangio-pancreatography (ERCP) and Endoscopic Ultrasound (EUS) systems have been installed at Holmesglen Private to meet the needs of advanced endoscopists, who are able to perform highly technical endoscopic investigations of the gallbladder and pancreas and/or endoscopic ultrasound of the gastrointestinal tract.

Endoscopic retrograde cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) combines both endoscopy (use of a long tube with a light and camera at the tip) and x-rays, to examine the drainage tubes (ducts) of the liver, gallbladder and pancreas.

Once the endoscope reaches the papilla, the place where the pancreas and bile ducts meet, a thin tube will be inserted through the endoscope and a dye and/or a wire is inserted into the ducts. X-ray images are taken to diagnose any problem related to the ducts. In case a problem is detected the doctor may give treatment at the same time.

  • Stone removal: Extraction of a stone lodged in the duct obstructing the flow of bile.
  • Stenting: A small plastic or metal tube is left inside the pancreatic or bile duct through ERCP to open up the narrow area in them.
  • Sphincterotomy: The sphincter is a cylindrical muscle functioning similar to one way valve regulating the flow of bile and digestive juices from the bile and pancreatic duct into the small intestine. It sometimes becomes hard and becomes narrow. The sphincter is enlarged using electrically heated wire in ERCP.
  • Biopsy: removal of a small sample of tissue for analysis.
  • Balloon dilatation: Due to cancer, gallstones, inflammation or scar tissue narrowing of the pancreatic or bile duct ducts may occur. A balloon is inflated inside the narrow portion of these ducts to open them through ERCP.

ERCP is typically performed as a day procedure, under sedation. The procedure usually takes 30min to one hour. Consult your physician for their exact pre and post procedure instructions.

Endoscopic Ultrasound (EUS)

Endoscopic Ultrasound (EUS) combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs.

In EUS a small ultrasound transducer is installed on the tip of the endoscope. By inserting the endoscope into the upper or the lower digestive tract one can obtain high quality ultrasound images of the organs inside the body. Because of the proximity of the EUS transducer to the organ(s) of interest, the images obtained are frequently more accurate and more detailed than the ones obtained by traditional ultrasound or other imaging modalities.

EUS combines two modalities, endoscopic visualization and high-frequency ultrasound, which represents an advantage over other imaging modalities, particularly in permitting precise delineation of the individual layers of the gastrointestinal tract Endoscopic Ultrasound is the most effective means of confirming the diagnosis of pancreatic disease. EUS provides an excellent means of tissue acquisition with a high overall diagnostic accuracy.

EUS is now considered a fundamental component of the accurate staging and management of number of benign and cancerous lesions of upper GI tract and mediastinum.

  • Staging cancers of the esophagus, stomach, pancreas and rectum
  • Mediastinal staging of non-small cell lung cancer and the evaluation of posterior mediastinal masses
  • Assessment of submucosal lesions, thickened gastric folds, and a variety of benign disorders, including bile duct stones (choledocholithiasis) and chronic pancreatitis
  • Assessment of intra-abdominal lymphadenopathy
  • Tissue sampling of pancreatic masses and cysts, submucosal lesions, lymph nodes and other mass lesions of the gastrointestinal tract and mediastinum requiring definitive diagnosis.
  • Therapeutic indications including biliary and pancreatic collection drainage procedures and Celiac plexus neurolysis.

EUS is typically performed as a day procedure, under sedation. The procedure usually takes 30min to one hour. Consult your physician for their exact pre and post procedure instructions.

Specialists performing ERCP and EUS:

Currently Holmesglen Private Hospital has two onsite physicians utilizing this state of the art equipment.

  • Advanced Endoscopy - Dr Leon Fisher 9589 1885
  • Victorian Gastroenterology - Dr Michael Swan 8677 7446

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