ERCP

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 * Source #1**

The site provides much detail on what an ECRP is and how one is performed as well as risks and side effects

PROCEDURE -patient is sedated -patient has an endoscope inserted through his/her throat -X-ray dye is injected; tissue samples are retrieved, etc

POSSIBLE SIDE EFFECTS -sore throat -bloating -gas -stretching of stomach -gagging

COMPLICATIONS -reaction to dye (nausea, hives, burning sensation, blurred vision, and urine retention) -breathing problems -low blood pressure -internal bleeding (very rare) NOTE: these complication are rare having less than 10%

Ro¨sch, T., V. Schusdziarra, et al. (2000). "Modern Imaging Methods Versus Clinical Assessment in the Evaluation of Hospital In-Patients With Suspected Pancreatic Disease." __THE AMERICAN JOURNAL OF GASTROENTEROLOGY__ **95**(9): 2261-2270.
 * Source #2**

The article is about an experiment in which ECRP, CT, and EUS were tested and compared to each other.


 * **Diagnosis** || **EUS** || **ERCP** || **CT** ||
 * Pancreatic disease //versus// normal pancreas || || || ||
 * Sensitivity || 93% || 89% || 91% ||
 * Specificity || 94% || 92% || 78% ||
 * Pancreatic cancer //versus// chronic pancreatitis || || || ||
 * Sensitivity || 86% || 81% || 81% ||
 * Specificity || 87% || 85% || 83% ||
 * Pancreatic cancer //versus// inflammatory tumors || || || ||
 * Sensitivity || 86% || 81% || 81% ||
 * Specificity || 72% || 61% || 72% ||


 * || **PPV** || **NPV** ||
 * EUS || 99% || 77% ||
 * ERCP || 98% || 66% ||
 * CT || 94% || 67% ||

NOTE: The prevalence of pancreatic disease in this patient group was 80%.

As can be seen EUS is more effective than ERCP, while CT and ERCP are similar

Another fact that I picked up from the combination of this source and another one (not used) is that these tests cant be done to a lot of people for different reasons -On this test 18 out of 184 people were excluded for different problems (They were not fit for testing etc) -Similar things were seen in other articles

ANG, T. L., E. K. TEO, et al. (2007). "Endosonography- vs. endoscopic retrograde cholangiopancreatography-based strategies in the evaluation of suspected common bile duct stones in patients with normal transabdominal imaging." __Alimentary Pharmacology & Therapeutics__ **26**(8): 1163.   The article provides a comparison of EUS to ERCP in both statistical and cost analysis.
 * Source #3**

|| **Sensitivity** || **Specificity** || **PPV** || **NPV** || 84-100% || 100% ||  100% ||  93% ||
 * EUS** ||
 * EUS** ||

NOTE: The Specificity, PPV, and NPV for ERCP were not provided (The sensitivity was 79-90%

ERCP was considered to be more cost effective (mean cost of $1601 compared to $1767) EUS and ERCP had similar accuracy (EUS: 93% ERCP: 92%) EUS was more specific EUS was less invasive and less likely to cause complications

NOTE: In this test 30% of patients were excused from an unnecessary ERCP because EUS readings.

The article concludes that EUS is more effective