Professor Yang Yulong І unveiled the "mystery" of ERCP technology and explored the "universe" under the endoscopy

Although biliary and pancreatic disease is a common clinical disease, it has become an urgent clinical problem due to its complicated etiology and high complication rate
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The advent of endoscopic retrograde cholangiopancreatography (ERCP) has created a new field of treatment for biliary and pancreatic diseases
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China's ERCP technology started in the early 1970s, after nearly half a century of progress, development and promotion, it has now become an important means of diagnosis and treatment of biliary and pancreatic diseases
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In this regard, Yimaitong invited Professor Yang Yulong from Dongfang Hospital of Tongji University to introduce us the current application status and future development of ERCP
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Expert Profile Professor Yang Yulong, Doctor of Medicine, Professor/Chief Physician, Doctoral Supervisor, Postdoctoral Workstation Supervisor, Special Allowance Expert of the State Council, Shanghai Talent Introduction Deputy Director of the Cholelithiasis Center of Dongfang Hospital Affiliated to Tongji University, Director of Hepatobiliary and Pancreatic Surgery, Shanghai Tongji University School of Medicine Cholelithiasis Deputy Director of the Institute, Deputy Chairman and Secretary-General of the Professional Committee of Endoscopy Minimally Invasive Biliary Protection, Chinese Medical Doctor Association, and Chairman of the Youth Committee, Chairman of the World Association of Endoscopy Doctors, and Chairman of the Chinese Association of Cholangiopancreatic Duct Endoscopy.
"The "big" world in endoscopy has been around since its inception in the late 1960s.
ERCP technology has gone from scratch, from diagnosis to treatment, from biliary system to pancreas, from technical application to prevention of complications, and from quality control to The development history of training
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With the advancement of medical technology, ERCP technology has become a "weapon" in the hands of endoscopists.
It provides high-quality minimally invasive treatments for patients with pancreatic diseases through minimally invasive methods
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Professor Yang Yulong pointed out that ERCP is the abbreviation of endoscopic retrograde cholangiopancreatography, which is to enter the duodenal area through the human mouth, esophagus, and stomach, and observe the duodenal papilla under the endoscope.
Introduce special instruments for intubation imaging, complete a series of operations under X-rays such as duodenal papilla incision, balloon dilation, and stone removal baskets to remove stones
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ERCP can not only diagnose, but also treat pancreatic, bile duct, and duodenal papilla diseases.
It is a minimally invasive endoscopic surgery
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With the maturity of operation technology and the improvement of various accessories, the safety and effectiveness of ERCP operation have also been generally recognized in the industry
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It does not require general anesthesia, the operation process is similar to that of a gastroscope, and the patient is well tolerated.
It can get out of bed within a few hours after surgery and can be discharged after a few days of observation.
Therefore, it is gradually recognized and accepted by clinicians and patients
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The advantages of ERCP include less trauma, less patient pain, quick postoperative recovery, short hospital stay, and strong repeatability
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Moreover, as long as the operation technology is mature and trained doctors can complete it, it is relatively safe
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ERCP minimally invasive technology "under the mirror": ERCP clinical application and thinking after decades of development, ERCP has become a more mature minimally invasive interventional technology, but any kind of technology, no matter how small the trauma, it is Invasive
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Professor Yang Yulong pointed out that minimally invasive techniques are relatively speaking, and that minimally invasive techniques like ERCP also have certain risks
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Common complications include bleeding, perforation, and pancreatitis
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Because the duodenal wall is very thin, if the personnel operate improperly or the operation rhythm is not well grasped, perforation and bleeding may occur
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Aiming at the problem of perforation, with the improvement of the technical level of endoscopic operation and the strengthening of standardized operation, it has been possible to avoid the occurrence of perforation or to solve it through surgery.

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The updated development of materials science also gives more options for hemostasis methods.
The most common method is to use hemostasis clamps to stop bleeding, followed by high-frequency electrosurgical devices (monopolar, bipolar electrocoagulation) and other hemostatic devices
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For patients with poor coagulation mechanism, acute balloon expansion or prone to bleeding, metal peritoneal stents can be used to compress the bleeding
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In addition, post-ERCP pancreatitis (PEP) is a more serious complication
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The treatment of PEP can usually be handled by placing pancreatic duct stents and minimally invasive surgery
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Professor Yang Yulong also introduced that ERCP is a retrograde cholangiopancreatography.
It is first of all an inspection method.
This technique can be used as long as there is a problem with the bile-pancreatic duct or the confluence of the bile-pancreatic duct
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At present, for pediatric patients, there are usually doctors who specialize in children's ERCP operations; for adult patients with common bile duct stones, common bile duct stenosis, pancreatic duct stenosis, pancreatitis, pancreatic duct stones, and nipple diseases, including elderly patients , And patients who are in poor physical condition and cannot tolerate surgery, also have the opportunity to use ERCP technology
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Therefore, ERCP technology has a wide range of applications
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Among the patients of Professor Yang Yulong, there are also centenarians, patients over 90 years of age with heart failure, patients with poor cardiopulmonary function, diabetes patients, patients who cannot tolerate surgery, and patients with higher risks of surgery.
These patients can all pass the ERCP technology.
Get treatment
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Regarding the future development of ERCP technology, Professor Yang Yulong said that with the advancement of endoscopy technology, especially the advancement of optics and materials science, many high-end and sophisticated accessories have been derived, which further broadens the application scope of ERCP endoscopy
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Therefore, ERCP technology may become the first choice for cholangiopancreatic duct disease and cholangiopancreatic duct confluence disease in the future
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"Our center carries out thousands of ERCP operations each year
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But this is not to say that more and more patients with biliary and pancreatic diseases, but that many diseases can already be diagnosed through ERCP technology and can be treated
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" Professor Yang Yulong added
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With the rapid development of medical technology, minimally invasive treatment will become the main theme in endoscopic treatment
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The realization of minimally invasive surgery through endoscopy will further reduce surgical trauma, reduce the pain of patients during treatment, and bring hope and confidence to more patients
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