Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic Retrograde Cholangiopancreatography, commonly referred to as ERCP, is a specialized endoscopic procedure performed by experienced gastroenterologists to diagnose and treat conditions of the bile ducts, gallbladder, liver, and pancreas.

Unlike routine endoscopic procedures, ERCP is primarily a therapeutic procedure, meaning it is most often used to treat known problems rather than simply diagnose them.

Why Is ERCP Performed?

ERCP is recommended to evaluate or treat conditions affecting the bile ducts or pancreatic ducts, including:

Gallstones lodged in the bile duct
Blockage or narrowing of the bile ducts
Bile duct leaks
Pancreatitis related to ductal obstruction
Abnormal liver function tests due to bile duct disease
Biliary or pancreatic strictures
Certain tumors affecting the bile or pancreatic ducts

ERCP allows physicians to both identify the problem and intervene during the same procedure.

How Is ERCP Different from Other Endoscopic Procedures?

ERCP combines endoscopy and fluoroscopic (X-ray) imaging to visualize and treat the bile and pancreatic duct systems.

Key differences include:

Access to the bile and pancreatic ducts
Ability to remove stones, place stents, or relieve obstructions
Use of contrast dye and X-ray guidance
More specialized equipment and training

Because of its complexity, ERCP is performed only when clearly indicated and by gastroenterologists with advanced endoscopic expertise.

What Happens During an ERCP?

ERCP is performed while you are comfortably sedated.

During the procedure:

An endoscope is passed through the mouth into the stomach and duodenum
A small catheter is used to access the bile or pancreatic ducts
Contrast dye is injected to visualize the ducts using X-ray imaging
Therapeutic interventions may be performed, such as:
- Removal of bile duct stones
- Placement of stents
- Dilation of narrowed ducts
- Treatment of leaks or obstructions

The length of the procedure varies depending on complexity.

Will I Feel Anything?

Patients do not feel pain during the procedure due to sedation. Afterward, some patients may experience mild sore throat, bloating, or abdominal discomfort.

Your care team will monitor you closely during recovery.