title: ERCP during pregnancy.
abstract: OBJECTIVE
  ERCP during pregnancy is always challenging for the entire team performing the endoscopic intervention. In this study techniques and different interventional aspects used at several centres about the clinical experience on ERCP in pregnant women are analyzed.
  
  
  METHODS
  the practice on ERCP in pregnant women in six centres during a period of ten years is reported.
  
  
  RESULTS
  eleven patients were included in the study. Mean age was 30.6 years. Indication for ERCP was always symptomatic common bile duct stone (CBDS) disease. Before the procedure abdominal ultrasound was performed at all times and magnetic resonance cholangiopancreatography in four occasions. Conscious sedation by means of midazolam and fentanyl or meperidine was applied. Sphincterotomes and guidewires were used for bilary cannulation. Sometimes, rapid exchange platforms with short-length guidewires controlled by the same endoscopist were employed. Biliary cannulation was confirmed in 9 occasions by bile aspiration. In five procedures, a mean of 30 seconds of fluoroscopy was used, both to verify cannulation and to corroborate complete CBDS clearance. These patients had the pelvic zone protected with a lead shield and radiation dose was measured. Ten biliary sphincterotomies were performed followed by CBDS extraction. Two plastic stents were inserted. Relief of biliary obstruction was attained in all circumstances. Only one patient had hyperamylasemia after ERCP. All pregnant women had healthy foetuses with normal deliveries.
  
  
  CONCLUSIONS
  with experience, ERCP appears to be a safe technique during pregnancy. With simple measures fluoroscopic time can be diminished or even abolished. It seems that ERCP during pregnancy is underused in our working areas, although it has shown to be a useful technique for relieving biliary obstruction.
authors.affiliation: Department of Digestive Diseases, Hospital Virgen de la Luz, Cuenca, Spain. endoscopia@endoscopiaintervencionista.org
authors.forename: Jesús
authors.initials: J
authors.lastname: García-Cano
authors.forename: Manuel
authors.initials: M
authors.lastname: Pérez-Miranda
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez-Roldán
authors.forename: Pedro
authors.initials: P
authors.lastname: González-Carro
authors.forename: Ferrán
authors.initials: F
authors.lastname: González-Huix
authors.forename: Claudio
authors.initials: C
authors.lastname: Rodríguez-Ramos
authors.forename: Antonio
authors.initials: A
authors.lastname: Naranjo
authors.forename: Juan Ángel
authors.initials: JÁ
authors.lastname: González-Martín
authors.forename: Carlos
authors.initials: C
authors.lastname: de la Serna
mesh_terms: D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D034321:Hyperamylasemia / Q000209:etiology; D011183:Postoperative Complications; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome