PROCEDURE

Dr Pretorius slides a bendable endoscope in the patient's mouth through to the upper digestive system. He injects non-toxic contrast dye which exposes strictures, injuries, pancreatic stones or gallstones. To dilate strictures, extract gallstones and drain fluid, the surgeon inserts miniaturised tools through the endoscope. The ERCP procedure allows Dr Pretorius to diagnose and treat the illness present in the pancreas or bile duct. Treatment depends on the diagnosis, and some of the surgeries that may be required are:

• Sphincterotomy: Sphincterotomy is a type of procedure that widens the duct opening into the intestine. During a sphincterotomy, the surgeon makes an incision on the papilla of Vater to widen the bile duct. A sphincterotomy helps drain ducts or pass out stones through the intestine.

• Stenting: A stent is a tiny tube that's left in the blocked duct to drain fluid. First, Dr Pretorius may need to stretch the duct before he places a stent. Stents are either temporary or permanent. Some stents pass out of the body naturally while others need to be replaced after three months or require removal.

• Stone extraction: A balloon or basket may be used to extract a stone that is stuck within the bile duct or pancreatic duct. A sphincterotomy usually precedes this procedure to improve success. In some cases, a special CRE balloon may be used to stretch the opening before the stone can be extracted.

RECOVERY

A rare complication of ERCP is pancreatitis, which is inflammation of the pancreas. Although this complication is unlikely, the patient must stay overnight in the hospital to receive intravenous fluid and pain medication. If pancreatitis develops, inflammation only lasts for a few days. A follow-up appointment with Dr Pretorius may be necessary to assess the patient’s overall health after the ERCP procedure. Other rare complications documented in the literature are bleeding and perforation.