Endoskopowa cholangiopankreatografia wsteczna, zwana ECPW/ ERCP jest zabiegiem inwazyjnym, który wykonuje się ze ściśle określonych wskazań. Jak każdy tego typu zabieg terapeutyczny niesie za sobą ryzyko wystąpienia powikłań, które dotykają 4-12 proc. pacjentów.
Do najczęstszych powikłań po endoskopowej cholangiopakreatografii wstecznej zalicza się symptomy łagodnego i szybko ustępującego zapalenia trzustki lub przewodów żółciowych, krwawienie i przedziurawienie przewodu pokarmowego (wówczas zachodzi ryzyko konieczności leczenia operacyjnego), a także powikłania dotyczące znieczulenia podawanego do zabiegu.
Wskazania do endoskopowej cholangiopakreatografii wstecznej
Endoskopowa cholangiopankreatografia wsteczna należy do czołówki najskuteczniejszych metod, które są w stanie ocenić drogi żółciowe oraz przewody trzustkowe. Metody tej nie stosuje się w diagnostyce, z uwagi na jej inwazyjność. Wykorzystuje się ją jedynie w celu wykonania zabiegu terapeutycznego.
Wskazaniem do ECPW jest m.in. diagnostyka i leczenie chorób dróg żółciowych i trzustki. Aby zminimalizować ryzyko wystąpienia powikłań, zabieg ten wykonuje się ze ściśle określonych wskazań, takich jak wystąpienie objawów lub dolegliwości odczuwanych przez pacjenta, a także nieprawidłowe wyniki badań laboratoryjnych i obrazowych. Wówczas zachodzi podejrzenie chorób dróg żółciowych bądź trzustki.
Jakie objawy świadczą o wskazaniu do ECPW?
Zabieg endoskopowej cholangiopakreatografii wstecznej wykonuje się u pacjentów z żółtaczką. Ponadto zabieg ten należy również wykonać w przypadku wystąpienia bólu brzucha, który może wskazywać na potencjalną obecność w drogach żółciowych przeszkody, w postaci złogów bądź zwężenie dróg żółciowych o różnej etiologii (pozapalne, nowotworowe, po zabiegach, takich jak m. in. zabieg usunięcia pęcherzyka żółciowego – cholecystektomia).
Endoskopowa cholangiopankreatografia wsteczna powinna zostać wykonana w przypadku wystąpienia zmian w narządach najbliższych w stosunku do dróg żółciowych, jak również zmian uciskających je z zewnątrz (m.in. w przypadku guza trzustki). Ponadto wskazaniem do wykonania ECPW będzie również podejrzenie kamicy żółciowej w drogach żółciowych czy pęcherzyku żółciowym.
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