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Endoscopic Retrograde Cholangiopancreatography – ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic test to examine the duodenum, the bile ducts, the gallbladder and the pancreatic duct.

How is ERCP done?

The procedure is performed by using a long, flexible, viewing instrument the duodenoscope. The duodenoscope can be directed and moved around the many bends of the stomach and duodenum. The duodenoscope is inserted through the mouth, through the back of the throat, down the food pipe (esophagus), through the stomach and into the duodenum. Once the papilla of Vater is identified, a small plastic catheter (cannula) is passed through an open channel of the endoscope into the opening of the papilla, and into the bile ducts and/or the pancreatic duct.

Contrast material (dye) is then injected and X-rays are taken of the bile ducts and the pancreatic duct. An open channel in the endoscope also allows other instruments to be passed through it in order to perform biopsies, to insert plastic or metal tubing to relieve obstruction of the bile ducts or pancreatic duct caused cancer or scarring, and to perform incisions by using electrocautery.

Indications for ERCP

Very rarely an ERCP is done for diagnostic purposes. It could be for biliary diseases in terms of stones, strictures and also in Pancreatic diseases in Acute as well as Chronic Pancreatitis and some tumors.

Complications of ERCP

Complications are infrequent, however can occur. Serious complications are rare. Bleeding is a complication that can occur. Resurgery may be required in about 10% of the cases. Perforation can occur and so can cholangitis.

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