Diagnosing digestive diseases can be complicated and challenging. Physical exams, blood tests and imaging scans aren’t always enough. Sometimes, advanced diagnostic procedures are needed, particularly when detecting and treating diseases of the pancreas, bile ducts and gastrointestinal tract.
In the Yale Medicine department of digestive diseases, our endoscopists (gastroenterologists who use a flexible tube with a light and camera attached to it to see internal organs and sometimes deliver treatment) are highly skilled, trained and experienced. We perform many specialized procedures on an outpatient basis. These include endoscopic ultrasound, radiofrequency ablation (RFA), endoscopic mucosal resetion, endoscopic retrograde cholangiopancreatography (ERCP) and esophagogastroduodenoscopy (EGD with stent).
“Our goal is to give informative answers,” explains Yale Medicine’s Harry Aslanian, MD. “We have specially trained physicians and we work in a multidisciplinary fashion, which gives you the confidence that you are in the right hands.”
What advanced diagnostic procedures offered at Yale Medicine?
Some of the advanced diagnostic procedures we offer include:
- Endoscopic Mucosal Resection (EMR): For some patients, EMR may be an effective alternative to surgery with quicker recovery and lower risk of complications. EMR is helpful in carefully evaluated, early, precancerous lesions of the esophagus, stomach, duodenum (the first part of the small intestine immediately beyond the stomach) and colon. For patients with Barrett’s esophagus, EMR is often used along with another treatment called RFA.
- Endoscopic Retrograde Cholangiopancreatography (ERCP): An ERCP uses an endoscope and X-rays to help doctors see tumors, blockages and stones in the pancreas and bile ducts. ERCP lets doctors guide special instruments into the bile and pancreas ducts. Once there, they can retrieve tissue samples, remove or crush gallstones, drain cysts and place stents to widen and open narrowed ducts. This procedure is similar to the endoscopic ultrasound, but also has the ability to take an X-ray. Your doctor will inject a contrast dye into the drainage hole of the bile and pancreatic ducts, which then provides a better X-ray image that enables your doctor to diagnose and treat any blockage.
- Esophagogastroduodenoscopy with enteral stent (EGD with stent): This procedure is used to treat tumors causing strictures (narrowing) or blockage of the esophagus, stomach, duodenum or colon. The stent is a soft mesh tube that expands the blockage to allow food and intestinal contents to pass through.
- Probe-Based Confocal Laser Endomicroscopy (pCLE): We are the only medical group in the region offering this procedure, which is used for the early detection of cancerous and precancerous conditions. The laser probe allows us to detect cancerous or precancerous tissue with highly magnified cellular imaging. Precancerous lesions can be immediately evaluated to guide endoscopic resection.
Are there risks to these procedures?
Endoscopy is a safe procedure, with a complication rate of about 1 in 2,000. Possible complications may include reactions to the anesthesia medications, making a hole in the digestive wall or bleeding. Certain procedures might have additional small risks and side effects, but they are minimal.
What stands out about Yale Medicine’s approach to advanced diagnostic procedures for digestive diseases?
Our team offers highly specialized multidisciplinary care from gastroenterologists, surgeons, oncologists, radiologists and pathologists. We work with your referring physician to quickly perform procedures and consultations. We take the time to explain and discuss your condition and all management choices.
As a group, we perform more than 2,000 complex endoscopies a year, making us one of the most experienced centers in New England. We use the most up-to-date, advanced procedures for diagnosing and treating complicated diseases of the pancreas, bile duct and gastrointestinal tract. We are also actively involved in education and research, including ways to lower the incidence of pancreatitis after ERCP and understanding the natural history of pancreas cysts, and acute and chronic pancreatitis.