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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure to diagnose and treat problems of the bile and pancreatic duct by combining upper gastrointestinal endoscopy and X-rays. For diagnostic purposes, the procedure is performed to find the cause of obstructive jaundice, chronic pancreatitis, and pancreatic tumor. For therapeutic purposes, the procedure can be performed to extract gallstones or other biliary debris, to treat the sphincter of Oddi (endoscopic sphincterotomy), to insert a stent into the common bile duct and/or the pancreatic duct, and to dilate the strictures.
Most of ERCP are carried out under local anesthetic, but in some cases, you may receive a general anesthetic. Your doctor inserts the endoscope (a long flexible tube with light and camera on its end) through your mouth and down to the esophagus, stomach, and the first part of the small intestine. Then, your doctor passes a tube through the endoscope and injects a dye, which will highlight the organ on the X-ray.
You can leave the hospital on the same day of the procedure or you may need to stay overnight. You’ll likely discuss the result of the diagnosis once you regained consciousness or the next day of the procedure. Plan to stay in Metro Manila for 2 to 3 days to allow for a recovery period.
You must rest for at least 24 hours and you should be able to resume your normal activities the next day after the surgery, but make sure to take things easy for a couple of days.
You will need to avoid strenuous activities for several days and follow a special diet during your recovery period. Your doctor will give you instructions on how to care for yourself after the procedure.
ECRP is safe and effective. However, it has been estimated that the procedure carries around 3.5 to 5 percent risk of post-ERCP pancreatitis (PEP). Other side effects and risks associated with ECRP include infection of the gallbladder or the bile duct, excessive bleeding (hemorrhage), perforation in the pancreatic or bile ducts, tissue damage from X-ray exposure, and an abnormal reaction to the sedative. Complications occur in about 5 to 10 percent of all ERCP procedures.
If ERCP is not the right procedure for you, your alternatives include endoscopic ultrasound, CT Scan, and MRI or MRCP (a special MRI of the bile ducts).
The result of ERCP will help your doctor confirm their diagnosis about your health problem, which will help them consider the best treatment option for you.
Whilst the information presented here has been accurately sourced and verified by a medical professional for its accuracy, it is still advised to consult with your doctor before pursuing a medical treatment at one of the listed medical providers
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Manila is the capital of the Philippines and is divided into 16 districts; it is one of the densest and populated cities of the world. Each district has its own history and cultural legacy. The city was under the rule of Spanish conquerors for almost three centuries. You can see the remains of that era in the ruins of the historical buildings. Today, the City is very modern with tall skyscrapers and modern architecture.
The Philippines is developing into one of the top countries in the world for medical tourism. Approximately 15 million people globally travel to other countries in search of quality medical care at affordable prices. Manila is a favorite destination due to the following reasons:
Manila Bay has many tourist spots and you will find many monuments that depict the Spanish occupation of the country. There are many Baroque Colonial Churches that will enable you to appreciate the artistic designs.
The National Museum of the Philippines, Bahay Chinoy, the National Art Gallery, and the Metropolitan Museum of Manila are some of the popular museums that you must visit in Manila. Rizal Park also known as Luneta is a historical urban park that is worth visiting.
There are also many organized tours that can help you get the best out of your sightseeing, for example, the Intramuros Tour, Rizal Park Tour, or the Skyscraper Gazing Tour and more.
Manila is a very modern contemporary city as the historical buildings have been replaced by modern architecture with better planning and layout and the buildings are earthquake resistant.
The city has many cultural and religious festivals throughout the year. There are plenty of shops, both big and small where you can buy branded goods at affordable prices.
The Philippines is a tropical country and in Manila, you will not experience too much temperature variations. January is the coolest month while May is the warmest month. The average temperature remains between 14°C and 38°C. The rainy season is between May and November. The rest of the months are dry. Manila is a humid city and bad weather such as Typhoons may occur during the months of June and September.
People traveling from nearby countries such as Malaysia and Indonesia can use the City’s sea entry points. For all other passengers, the best option is to take the air route.
The Ninoy Aquino International Airport is the City’s major international airport. It has four different terminals that connect via bus transfers. If you are taking a connecting flight, remember to keep some time as a buffer, as transfers may force you to travel through the busy streets of Manila. Terminal 1 caters to International flights and Philippine Airlines uses T2 and domestic carriers and international carriers use T3 with budget carriers largely using T4.
You can take a bus from the airport to the city. Taxis have meters and you can hail a cab outside the airport. Buses and small vans or jeepneys are popular modes of transport within the city.
Manila has three light rail systems and one heavy train line. The light rail systems are the LRT-1, LRT-2, and MRT-3. You can also use the pedicabs and tricycles for shorter distances. In some areas, you can even find horse-driven carriages called calesa.
The visa process is not a very complex system as the Philippines has a visa waiver program for certain countries. All European nations, South American countries, and many others form part of this program. Citizens from these countries can stay in Manila for up to 30 days, whereas nationals from Brazil and Israel may stay in Manila for 59 days. Hong Kong, Macau, and Portugal residents can stay for 14 days without a visa. Tourists belonging to other countries need to apply for a visa to enter the Philippines, in the consulate in their respective countries.
You must also have a valid return ticket. Passport must also be valid for at least six months and beyond to stay in the country. Visa-exempt people may extend their stay by one or two months after which they will have to apply for a visa.