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Endoscopic Retrograde Cholangiopancreatography (ERCP)

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:

  • Tumors
  • Pancreatitis
  • Gallstones
  • Cysts

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.