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Common Procedures

Oesophagogastroduodenoscopy (OGD) is a diagnostic endoscopic procedure that visualises the upper part of the gastrointestinal tract up to the duodenum. It is considered a minimally invasive procedure. It is a simple procedure and is usually done  with light sedation with little discomfort to the patient. It is an accurate procedure and can identify abnormalities and do biopsies if necessary. Complications from OGD are rare. 

Colonoscopy is the endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera on a flexible tube passed through the anus. In most cases, the endoscope is advanced to the caecum (end of colon) in under 10 minutes.

It provides a visual diagnosis (e.g. ulceration, polyps) and grants the opportunity for biopsy or removal of suspected lesions such as cancer. Colonoscopy can remove polyps smaller than one millimeter. Once polyps are removed, they can be sent for histology to determine if they are precancerous or not.  

Indications for colonoscopy include gastrointestinal hemorrhage, unexplained changes in bowel habit or suspicion of malignancy. Colonoscopies are used to diagnose colon cancer and other pathologies like inflammatory and ischemic bowel disease 

Due to the high mortality associated with colon cancer and the high effectivity and low risks associated with colonoscopy, it is now also becoming a routine screening test for people 50 years of age or older.

This procedure is usually done under sedation with minimal discomfort. There is occasional pain when junctions are negotiated. There is also occasional abdominal distension after the procedure. This is due to air insufflation. 

In experienced hands, morbidity is low and is about one in two - three thousand procedures. 

Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is an x-ray examination of the bile ducts which is aided by a video endoscope. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x rays.

 ERCP is used to relieve obstruction caused by stones or tumor. These can be removed or stented.

It is a procedure which should only be done by well trained doctors as it has an overall morbidity of 5%.  

Liver biopsy is done to arrive at a diagnosis of liver disease if other investigations are unable to clinch  a diagnosis. It is also used to assess the degree of liver damage in patient with chronic liver disease. It can be done by the bedside or via ultrasound guided. The risks of liver biopsy are low in experienced hands. Only local anaesthesia is required.

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