Difference Between ERCP and MRCP (with Table)

Pancreatic disease or Pancreatitis occurs when digestive enzymes become activated still in the pancreas causing inflammation and irritating cells of the pancreas. This can damage the pancreas and lead to chronic pancreatitis. ERCP and MRCP are the two types of diagnosis that can help in the Diagnosis and treatment of such diseases.

ERCP stands for Endoscopic Retrograde Cholangio-Pancreatography, is an invasive procedure of treatment that consists of inserting a tube ( fiber-like) called an endoscope with a camera at one end through the mouth of the patient till the pancreas and viewing the inside of the gastrointestinal tract.

MRCP stands for Magnetic Resonance Cholangio-Pancreatography, is a kind of diagnosis that consists of creating a magnetic resonance field generated by a magnetic resonance imaging machine around the body that then takes images for further treatment procedures. In MRCP contrast dye is not used as it is a completely non-invasive process.

The difference between ERCP and MRCP is the process and the equipment that is used. The ERCP uses Laparoscopy and Fluoroscopy. On the other hand, MRCP uses a magnetic resonance machine also called an MRI machine for the purpose of diagnosis.

Comparison Table Between ERCP and MRCP

Parameters of ComparisonERCPMRCP
DefinitionEndoscopic Retrograde Cholangio-Pancreatography is an invasive procedure for treating pancreatic diseases where an incision is required on the body of the patient.Magnetic Resonance Cholangio-Pancreatography, popularly known as MRCP, is a medical imaging technique that visualizes the pancreatic or biliary ducts with the use of non-invasive manners that can be used to determine the lodged gallstones.
ProcessIt includes inserting an endoscope(fiber-like tube) with a camera attached at one end, through the mouth of the patient to the pancreas, and then taking the view of the gastrointestinal tract from inside with the help of Fluoroscope.It creates a magnetic resonance field generated by a magnetic resonance imaging machine around the body that then takes images for further treatment procedures.
EquipmentERCP uses Laparoscopy and Fluoroscopy for the purpose of treatment.MRCP is done with the use of an MRI(Magnetic Resonance Imaging) machine.
CostERCP is very costly.MRCP is less costly.
RiskERCP involves a higher riskMRCP involves comparatively lesser risk.
ImportanceERCP is commonly used for the purpose of therapeutic.MRCP is commonly used for the purpose of diagnosis.

What is ERCP?

Endoscopic Retrograde Cholangio-Pancreatography, popularly known as ERCP is an invasive procedure for treating pancreatic diseases where an incision is required on the body of the patient.

It includes inserting an endoscope(fiber-like tube) with a camera attached at one end, through the mouth of the patient to the pancreas, and then taking the view of the gastrointestinal tract from inside with the help of Fluoroscope. When the endoscope reaches the gall bladder, a dye is injected into the ducts of the pancreas and inside the body is viewed through a Fluoroscope.

ERCP is used for the diagnosis of abnormalities in bile ducts and pancreatic ducts, it is also used for the treatment of obstructive jaundice. Gall bladder tumor and various ducts. This process can not be used on a person who has a history of myocardial infarction, clotting disorder, or who have undergone allergic reaction due to the use of dye.

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ERCP has been a remarkable advancement of technology over the past 50 years in the field of gastrointestinal endoscopy. It has redefined the medical and surgical approach to pancreatic disease. It was born initially as a diagnostic process to access diseases of the pancreaticobiliary system in the 1960s.

ERCP

What is MRCP?

Magnetic Resonance Cholangio-Pancreatography, popularly known as MRCP, is a medical imaging technique that visualizes the pancreatic or biliary ducts with the use of non-invasive manners that can be used to determine the lodged gallstones.

MRCP is used in cases with unexplained abdominal pain or the treatment of stones in common bile ducts, biliary dyskinesia, or cancer. There is low or uncertain morality of hepatobiliary pathology that is why this process is more often used by doctors.

It can not be used on a person who has previously undergone stent surgery. MRCP can not opt on someone who has a pacemaker implanted as the magnetic resonance will interfere in the working of the pacemaker.

MRCP was first introduced in 1991, and it was evolved from a technique with questionable potential. It has, at present, replaced diagnostic endoscopic retrograde cholangiopancreatography in a number of clinical scenarios. 

MRCP

Main Differences Between ERCP and MRCP

  1. Endoscopic Retrograde Cholangio-Pancreatography is an invasive procedure for treating pancreatic diseases where an incision is required on the body of the patient. As against, Magnetic Resonance Cholangio-Pancreatography is a medical imaging technique that visualizes the pancreatic or biliary ducts with the use of non-invasive manners that can be used to determine the lodged gallstones.
  2. It includes inserting an endoscope(fiber-like tube) with a camera attached at one end, through the mouth of the patient to the pancreas, and then taking the view of the gastrointestinal tract from inside with the help of Fluoroscope. On the other hand, MRCP creates a magnetic resonance field generated by a magnetic resonance imaging machine around the body that then takes images for further treatment procedures.
  3. ERCP is done with the use of Laparoscopy and Fluoroscopy and MRCP is done with the use of an MRI(Magnetic Resonance Imaging) machine.
  4. ERCP is more costly while MRCP is less costly.
  5. ERCP has a higher risk as compared to MRCP.
  6. ERCP is commonly used for therapeutic. Whereas, MRCP is commonly used for diagnosis.

Conclusion

ERCP and MRCP are two different kinds of technology that are used for the purpose of diagnosis and treatment of grievous diseases inside the human body. Both include imaging techniques for the purpose of treatment but they differ in the context of equipment, method, the experience they use.

Both have different origins and evaluations. In the present scenario, MRCP is most commonly preferred over ERCP considering the cost and risk involved.

References

  1. https://www.ajol.info/index.php/sajr/article/view/34514
  2. https://www.karger.com/Article/Abstract/78731
  3. https://www.giejournal.org/article/S0016-5107(02)70008-4/abstract
  4. https://europepmc.org/article/med/18265635