Acute pancreatitis on the rise but Endoscopic Retrograde Cholangiopancreatography (ECRP) can stem the tide

By Nick Rees

The pancreatic duct joins the pancreas to the common bile duct, which allows the pancreas to supply pancreatic juices to aid in the process of digestion.

This duct can become blocked, compressed, obstructed or inflamed, leading to acute pancreatitis, which a recent article in the British Medical Journal is on the rise over the last several decades.

Acute pancreatitis, an Erasmus Medical Center report says, affects 18 Americans per 100,000, while a study of European sufferers revealed that the incidence of acute pancreatitis has increased from 12.4 per 100,000 in 1985 to 15.9 per 100,000 in 19955. Despite this increase, however, mortality rates have stayed the same or even decreased.

One of the reasons for the lower mortality rate is the use of endoscopic retrograde cholangiopancreatography, or ECRP.

"ECRP can be used to diagnose and treat many conditions of the bile ducts, including cancer, gallstones,  and even infection," Dr. Tat-kin Tsang, a top rated doctor of internal medicine in Chicago, says.. "In ECRP, what we do is put an endoscope into the stomach and through to the duodenum, which is where the bile duct is to see what is obstructing or blocking the duct."

Dr. Tsang has studied the pancreas, the bile duct and its mechanisms for 25 years and has used his expertise not only in helping patients - Dr. Tsang has published numerous papers on the subject and has helped other doctors increase their knowledge.

"What we do all depends on what kind of blockage we find," Dr. Tsang says. "Stones can form in the gall bladder and travel into the bile duct. These stones can be pulled out of the duct during ECRP. If you don't take a stone out, it can become and infected and lead to death. If a narrow part of the duct is found, which can be caused by scar tissue or tumors, stents can be placed to prevent a blockage."

ECRP is not an invasive procedure, Dr. Tsang says, and leaves only a small scar.

"If the patient is stable and healthy, the procedure can be done as an outpatient procedure," Dr. Tsang says. "Recovery time is fairly quick. Patients are almost at 100 percent the day after the procedure. If the bile duct is obstructed and causing jaundice, once we unblock it, patients feel better quickly and see their appetites increase."

Complications from the procedure, Dr. Tsang says, are fairly rare, hovering at only about four percent based upon age and other medical problems.

Dr. Tat-Kin Tsang of Gastroenterology Consultants of the North Shore  was selected in 2010 by TopTierMD as a Chicago Top Doctor - He was named a Best Chicago Gastroenterologist specializing in Pancreaticobiliary disease / ERCP, Detection of H.pylori infection/ gastroscopy, MultiplexPCR, and Barrett's esophagus   / gastroscopy.  He practices in Wilmette, IL.