CPRE
The RETROGRADE ENDOSCOPIC CHOLANGIOPANCREATOGRAPHY (CPRE) is an invasive exam to treat diseases in the gallbladder and in the pancreas. It’s currently used for the treatment and not to diagnose alterations in these organs.
It’s performed in an outpatient environment, with the presence of an anesthetist doctor and usually under a general anesthesia. Usually, the patient is places in a vertical position and the radioscopy is used during the procedure.
The examination takes an average of 15 to 20 minutes to be completed at the discoveries dependencies and procedures that might be performed. After the exam, it’s necessary to remain about 12 hours at the post-anesthetic recovery, or to be hospitalized for the medical team that’s following the patient.
The patients that use antihypertensives medications must use them at the usual time and with a small amount of water. Diabetic patients that are currently using oral medications must not use them at the examination day. The insulin might be administered by half of its usual doses.
In case of anticoagulants, the doctor who required the exam must guide the patient about the possible needed time to suspend or interrupt its use. Sometimes the endoscopist discuss the used drugs with the patient’s doctor.
SEVERAL PROCEDURES MAY BE INDICATED AND NEEDED. SOME OF THEM MIGHT BE PERFORMED AT THE SAME MOMENT, BUT OTHERS MAY NEED A NEW SCHEDULE AND COMPLEMENTARY EXAMS. THE MAIN PROCEDURES PERFORMED ARE: ENDOSCOPIC PAPILLOTOMY OR INFUNDIBULOTOMIA, SWEEPING WITH BALLOON OR BASKET FOR THE REMOVAL OF CALCULATIONS AND BILIARY CLAY, PASSAGE OF A PLASTIC OR METALLIC PROSTHESIS SELF-EXPANDABLE AND BIOPSIES OR BRUSH FOR CYTOLOGY.
THE COMPLICATIONS SURROUNDING THE CPRE EXAM IS ABOUT 5 TO 10%. GENERALLY, THEY’RE SLIGHT AND EASY TO BE CLINICALLY SOLVED. PANCREATITIS IS THE MOST FREQUENT COMPLICATION AND ITS SOFT FORM IS THE MOST COMMON. IT’S NECESSARY TO REMAIN HOSPITALIZED AND FASTING. BLEEDINGS AND PERFORATIONS ARE POSSIBLE EVENTS, ESPECIALLY WHEN THERE ARE ASSOCIATED ANATOMIC ALTERATIONS. IN MOST CASES, THE ENDOSCOPIC OR CONSERVATIVE TREATMENT IS INDICATED, BUT THERE MIGHT BE THE NEED TO PERFORM AN URGENT SURGERY.
THE RESULT IS ATTACHED TO THE HANDBOOK AND, IF ANY HISTOPATHOLOGICAL STUDY HAD BEEN MADE, THE RESULT MUST ALSO BE SUBMITTED TO THE HANDBOOK OR WITHDRAWN BY THE PATIENT.
PREPARATION FOR CPRE