What is endoscopic Ampullectomy?

Endoscopic ampullectomy is a minimally invasive method of treating superficial lesions of the ampulla of Vater. With careful patient selection and lesion assessment it is a safe and efficacious therapeutic procedure that can obviate the need for potentially major surgical intervention.

What is the CPT code for endoscopic retrograde cholangiopancreatography?

43269
43269 Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde removal of foreign body and/or change of tube or stent. Distinct procedural service appended to the second code.

What is a Ampullectomy?

An ampullectomy is a surgical procedure that is used to treat cancers of the hepatopancreatic duct (ampullary adenomas), small neuroendocrine tumors that develop in the ampulla of Vater and certain noncancerous conditions, such as inflammatory stenosis.

What is ERCP in gastroenterology?

What is ERCP? Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope—a long, flexible, lighted tube.

Where is the Hepatopancreatic Ampulla located?

duodenum
The hepatopancreatic ampulla, also called the hepatopancreatic duct or ampulla of Vater, is a spherical structure located at the site of the confluence of the common bile duct and pancreatic duct, marking the entry point of bile into the second portion of the duodenum.

What does the Ampulla do?

The ampulla secretes a yellowish fluid, ergothioneine, a substance that reduces (removes oxygen from) chemical compounds, and the ampulla also secretes fructose, a sugar that nourishes the sperm.

Is fluoroscopy included in ERCP?

Endoscopic retrograde cholangiopancreatography (ERCP) is an important tool for the diagnosis and treatment of the hepatobiliary system. The use of fluoroscopy to aid ERCP places both the patient and the endoscopy staff at risk of radiation-induced injury.

What is Spyglass Cholangioscopy?

Spyglass cholangioscopy is the direct examination of the bile ducts using a small caliber scope. The Spyglass scope can be inserted into the bile duct or pancreatic duct to enable direct visualization during ERCP. and help obtain biopsy specimens, lead to the diagnosis of abnormalities, and guide stone therapy.

Are you awake during ERCP?

This is called “conscious sedation” because you are awake, but the body is relaxed and pain is numbed. In some more complicated cases, you may be sedated more heavily or given anesthesia (put to sleep) for the ERCP. For safety reasons, you will be asked to remove eyeglasses or contact lenses, and dentures.

Is ERCP a major surgery?

An ERCP is performed primarily to correct a problem in the bile ducts or pancreas. This means the test enables specific treatment. If a gallstone is found during the exam, it can often be removed, eliminating the need for major surgery.

What is bile Canaliculus?

Bile canaliculi are tiny, 1- to 2-μm wide tissue spaces formed by the apical membranes of adjacent hepatocytes. They form a delicate intralobular network of channels that drain bile produced by hepatocytes.

Where does pancreatic duct meet common bile duct?

The common bile duct and the main pancreatic duct join before emptying their contents into the duodenum through the papillary orifice at the end of the duodenal papilla—a small, nipplelike structure that extends into the duodenum.

Is the endoscopic ampullectomy a minimally invasive procedure?

Go to: Abstract Endoscopic ampullectomy is a minimally invasive method of treating superficial lesions of the ampulla of Vater. With careful patient selection and lesion assessment it is a safe and efficacious therapeutic procedure that can obviate the need for potentially major surgical intervention.

What are the CPT codes for endoscopy tests?

1 CPT Only ©2017 American Medical Association. 2 Endoscopic Ultrasonography – CPT Codes 43231- 45392. 3 The American Society for Gastrointestinal Endoscopy (ASGE) works to ensure that adequate methods are in place for. 4 gastroenterology practices to report and obtain fair and reasonable reimbursement for procedures, tests and visits.

When to cannulate PD after endoscopic ampullectomy?

Endoscopic mucosal resection (EMR) is used to resect the lateral spreading component and previously described standard ampullectomy technique is used at the end to remove the papilla itself. The PD should be cannulated as soon as the resection is complete. PD stenting has been reported to minimize post ampullectomy pancreatitis.

Are there any side effects of an endoscopic ampullectomy?

However, adverse events such as bleeding, pancreatitis and perforation, are not uncommon, and at times may be severe. Comprehensive pre-resection evaluation, a meticulous technique with a side viewing endoscope, and experience with management of complications (mainly bleeding), are crucial to ensure a safe and adequate resection.