Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopy procedure used to diagnose or treat problems in the liver, gallbladder, bile ducts and pancreas. It combines the use of X-rays and an endoscope (a lighted, flexible tube containing a camera) to allow a doctor to examine the area, take tissue samples, remove stones and insert stents (tiny wire mesh tubes) as needed.
Conditions for which a doctor might use ERCP include the following:
How does ERCP work?
- The back of your throat will be numbed with a local anesthetic (usually gargled or sprayed). You may also receive intravenous sedation to relax you. You’ll lie on your back or your side on an X-ray table.
- Your doctor will pass an endoscope through your mouth, esophagus and stomach into the duodenum, or the first part of the small intestine. The endoscope transmits video to a computer screen that the doctor can see.
- When the scope reaches the common opening to the biliary (liver) and pancreatic ducts, a catheter is passed through the endoscope and into the ducts. Dye is injected through the catheter to allow your doctor to see the ducts on X-rays, which will show any blockages or narrowed areas.
Depending on what the X-rays reveal, your doctor might pass special tools through the endoscope to do one or more of the following:
- Open blocked ducts or remove tumors in the ducts
- Break up or remove gallstones
- Insert stents, which are tubes placed into narrowed ducts to hold them open and restore the flow of bile or pancreatic juice
- Collect cells from inside the ducts to be examined for infection or cancer
Why choose Rush for ERCP
- Rush’s program to diagnose and treat gastrointestinal diseases and disorders, one of the most comprehensive in the Midwest, includes two interventional endoscopists who are experts in performing ERCP.
- Rush was one of the first hospitals in the United States to offer a form of ERCP called introductal choledochoscopy, also called the Spyglass procedure. Spyglass uses a special fiber-optic probe that gives doctors a better view, improving their ability to diagnose and reducing the need for further testing.
- ERCP and Spyglass allow doctors to see large, complex gallstones and use a process called hydraulic lithotripsy to break them into tiny fragments instead of removing them surgically.
- Rush specialists are also skilled in the innovative technique of endoscopic ultrasound (EUS), which uses sound waves to create an image of tissue if the traditional endoscope does not provide a good view.