By Peter B. Cotton
Advanced Digestive Endoscopy: ERCP addresses the most complicated diagnostic and healing strategies for endoscopists. It presents the most recent considering and transparent guide at the options, which were built-in with total sufferer care.
Written by means of the best overseas names in endoscopy, the textual content has been expertly edited by way of Peter Cotton right into a succinct, instructive layout. awarded in brief paragraphs based with headings, subheadings and bullet issues and richly illustrated all through with full-color pictures.
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Extra info for Advanced Digestive Endoscopy: ERCP
This paradoxical movement shortens the scope using the pylorus as a pivot, bringing it into the classical ‘short scope position’. The markings on the duodenoscope should indicate 60–65 cm at the incisors. 37 38 CHAPTER 3 With the patient prone, and the scope returned to a neutral position, the papilla can be easily visualized, in the middle of the second portion of the duodenum. The landmark for identiﬁcation of the papilla is the junction where the horizontal folds meet the vertical fold. Duodenal diverticula may cause difﬁculties with cannulation as the papilla may be located on the edge or rarely inside a diverticulum.
Fig. 8 Personnel protectiona OSHA regulation. Gowns, gloves (double), shoe cover, face shields or mask, lead apron and collar, X-ray badge, and lead lining for room and warning signs. facing the ﬂuoroscopy unit during screening. Individuals who need to turn around during ﬂuoroscopy should have both front and back protection. To reduce the weight of the lead apron on the shoulder, a skirt and a vest can be used. A lead collar should be worn to protect the thyroid gland, and lead glasses are recommended, especially if a ﬂuoroscopy unit with an over-couch tube is 27 28 CHAPTER 3 used.
4 Organize accessories within easy reach for retrieval. Do not stack up, ‘ﬁle’ like books in a library with large clear/‘correct’ labels. Categorize in groups. Special accessories and tools. Fig. 5 Organization of worktop: water with simethicone for irrigation; 30% alcohol; 4 × 4 gauze; 20 ml syringe with blunt needle adaptor; 1 : 10 000 epinephrine; clips. Organization of the worktop (Fig. 5) To minimize cross-contamination of unopened accessories it is preferable to separate the clean and soiled items onto different worktops.
Advanced Digestive Endoscopy: ERCP by Peter B. Cotton