Crozer-Chester Medical Center is committed to providing patients with cutting-edge endoscopic technology, some of which are usually only available at university medical centers.
Endosocopic Retrograde Cholangiopancreatography (ERCP)
A full-service, 24 hour, ERCP endoscopy unit is dedicated to the diagnosis and treatment of liver, bile duct, and pancreatic disorders. Board-certified anesthesiologists are frequently involved in cases in order that sedation is given safely, effectively and with minimal discomfort to the patient during the procedure. Patients with gallstones lodged in the bile duct can be treated by ERCP. Even oversized gallstones can be crushed using a mechanical lithotriptor and the gallstone fragments retrieved from the bile duct by specialized baskets, often avoiding the need for surgery.
Patients with bile duct or pancreatic tumors can be offered stent treatment that allows for improved quality of life.
Interventional Endoscopic Ultrasound (EUS)
Endoscopic ultrasound is the most significant technologic development in gastroenterology over the past decade. Crozer-Chester Medical Center is the only facility in Delaware County that has this state-of-the-art technology. An expert endoscopic oncologist uses EUS to stage intestinal, biliary, pancreatic and lung cancers before definitive treatment.
Where possible, the endoscopist can obtain biopsies from tumors, lymph nodes and other organs by a method called fine needle aspiration (FNA).
A multidisciplinary team of physicians, nurses, and support staff, in collaboration with the Crozer Regional Cancer Center, meet regularly to discuss the care of cancer patients. In addition, patients with severe abdominal pain from gastrointestinal cancers or chronic pancreatitis can be offered celiac nerve blocks by EUS. This frequently enables the patient to significantly decrease the daily usage of pain medications.
Endoscopic Mucosal Resection (EMR)
Confined, localized, and small precancerous or cancerous changes within the lining of the intestinal tract can be safely removed by EMR. The technique consists of a upper endoscopy or colonoscopy of longer than usual duration. Endoscopic ultrasound is usually performed just prior to EMR. EMR can be suitable alternative for patients who are seeking a nonsurgical option to remove an abnormality. An overnight stay in the hospital for monitoring may be required in some patients.
Capsule Endoscopy
Capsule endoscopy was recently developed and is used primarily to diagnose the cause of obscure intestinal bleeding. Prior to the procedure, the doctor usually performs a standard small intestine x-ray in order to make sure there is no evidence of intestinal obstruction. Capsule endoscopy involves swallowing a capsule that measures 3 cm by 1 cm, the size of a large pill. Once swallowed, the device automatically begins transmitting digital images in regular intervals to a receiver worn by the patient (similar to a Walkman). The patient can then leave the doctor’s office. After 8 hours, the patient returns to the office so that the images in the receiver can be uploaded to a computer for analysis. The capsule is passed from the rectum usually without any problems. This new technology has replaced the extremely complex, uncomfortable, and lengthy Sonde enteroscopy that had been used in the past to visualize the small intestine. Small intestinal abnormalities such as vascular malformations and tumors can be detected by capsule endoscopy. Once the diagnosis has been made, definitive treatment can be offered.