mercoledì, maggio 18, 2005
:: my first ERCP ::ok, i know this is riDIculous, but i've just only seen my first ever ERCP (endoscopic retrograde cholangiopancreatography) ie. put a scope into your stomach, find the place where the bile and pancreatic ducts open into the duodenum and stick the nozzle of the catheter there, then shout 'fluoro!' while pressing on the syringe containing the dye with the X-ray on... and voila! u can see the ducts all nicely lit up, showing filling defects that represent possible stones or growths in the ducts... it's also possible to demonstrate strictures and other things.
it was quite exciting hehe... first that guy found the ampulla of vater, and then he put this guide wire in to guide the catheter thingy into the duct... he used fluroscopy and contrast to identify the bile duct. next up was to do a papillotomy (that is use the diathermy to cut the papilla so that the opening is now wider) the final step is actually to introduce the catheter, and a dormia basket, which is used to capture and retrieve the stone... unfortunately, that guy did not do a sufficient papillotomy and he lost the location of the opening. even 'dua tow' couldn't find it... at that point, with all the diathermy and needle prodding (he actually aptly named it 'thaipusam') and trying all the different types of stylets, the engorged papilla (from all the prodding and cutting) looked like a perfectly ulcerative, malignant tumour... lolz... dunno what 'apple coil lesion'. it took ages, and the poor man was given more valium and buscopan.
now, why did the dua tow say valium is better than dormicum?
so sad, i didn't get to see them use the dormia basket :(
next week, they're going to redo the ERCP, perhaps i'll go join them again!
i believe, as a person, we should see things thru and not give up halfway.
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francesca chiu
2 eyebags & 5 wrinkles
on long-term dormicum drip
KIV IMH
icq: 58631104
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