The Biliary and Pancreatic Disorders practice offers diagnosis and treatment for various disorders of the gallbladder, pancreas, and bile ducts. Bile, a substance that aids the digestion and absorption of fats, is carried from the liver by the bile ducts. The gallbladder stores the bile between meals and empties it back into the bile duct, once food is consumed. Another duct allows digestive juices from the pancreas to mix with food in the intestine. Problems in these organs and passageways include infection, blockages, stones, and cancer.
Physicians at BMC offer a procedure known as endoscopic retrograde cholangiopancreatography (ERCP) to diagnose and sometimes treat these problems. ERCP involves placing an endoscope into the mouth through the esophagus and stomach into the duodenum (part of the small intestine). Sometimes, the problem can be identified and solved in one procedure. If not, te procedure is often followed by a laparoscopic (minimally invasive) surgical procedure to remove the gallbladder.
The Biliary and Pancreatic Disorders Practice provides care to patients with the following conditions:
- Bile duct injuries or strictures
- Cholecystitis
- Gallbladder disease
- Gallstones
- Pancreatic and biliary tumors
- Pancreatitis
Conditions listed above can be diagnosed by
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Endoscopic Retrograde Cholangiopancreatography (ERCP)
During an ERCP, the gastroenterologist uses an endoscope, a long, thin, flexible tube with a light and camera at the end, through the esophagus, the stomach, and the first part of the small intestine, called the duodenum. Once the endoscope reaches the papilla, which is the opening of the common bile duct, the physician injects dye through these ducts, enabling x-rays to be taken. A physician may recommend an ERCP if the patient is experiencing abdominal pain or develops jaundice.
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Endoscopic Ultrasound (EUS)
Your physician uses an endoscope (a long, flexible tube) with a small ultrasound transducer on the tip to obtain images of the lymph nodes deep in the chest. This instrument is passed into your esophagus. The transducer sends high-frequency sound waves to the organs to create detailed images of them. You should avoid food and drink for at least 6 hours before the procedure, and you will be sedated, so you should not drive or return to work for 24 hours.
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Fine Needle Aspiration (FNA) Biopsy
FNA uses a thin, hollow needle (thinner than the needles used to draw blood) to draw out fluid or tissue from a lump. Depending on the size and location of the lump, the needle is sometimes directed into the lump simply by feeling it. Other times it may be guided into the lump with the assistance of an ultrasound. FNAs are rarely painful and don’t tend to leave scars. Although FNA is the easiest type of biopsy to have, it doesn’t always provide a clear result.
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Magnetic Resonance Imaging (MRI)
This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be asked to drink a contrast solution for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implant.
Treatment options for the conditions listed above include
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Stents
A stent is a small mesh tube that's used to treat narrow or weak arteries.
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Stricture Dilation
The opening of a narrow vessel.