ERCP

Category

ERCP

ERCP is one of the most advanced therapeutic endoscopic procedures used for the diagnosis and treatment of diseases affecting the bile ducts, gallbladder, pancreas, and pancreatic ducts. By combining endoscopy with fluoroscopic imaging, ERCP allows access to the biliary and pancreatic systems without the need for open surgery. It is considered the treatment of choice for many pancreatobiliary disorders and has transformed the management of jaundice, bile duct stones, and biliary obstruction

Common Conditions Treated with ERCP

Obstructive Jaundice

 

Obstructive jaundice occurs when the normal flow of bile is blocked by gallstones, strictures, pancreatic diseases, or cancers. Patients may develop yellowing of the eyes, dark urine, itching, pale stools, and fever. ERCP helps identify the cause of obstruction and provides immediate therapeutic relief through stenting or stone removal.

 

Common Bile Duct Stones (Choledocholithiasis)

 

Bile duct stones can cause severe abdominal pain, jaundice, cholangitis, and pancreatitis. ERCP remains the gold standard treatment for removing stones from the bile duct. Most patients can avoid major surgery through endoscopic stone extraction.

 

Acute Cholangitis

 

Acute cholangitis is a serious infection of the bile ducts that requires urgent intervention. ERCP allows rapid decompression of the obstructed biliary system, helping control infection and prevent life-threatening complications.

 

Benign and Malignant Biliary Strictures

 

Narrowing of the bile ducts may result from inflammation, previous surgery, chronic pancreatitis, or cancer. ERCP enables accurate diagnosis and effective treatment through balloon dilatation and stent placement.

 

Pancreatic Duct Disorders

 

ERCP is frequently used in patients with chronic pancreatitis, pancreatic duct strictures, pancreatic duct leaks, and pancreatic stones. Therapeutic interventions can improve symptoms and prevent complications.

 

Advanced ERCP Procedures

Endoscopic Sphincterotomy

 

A controlled incision is made at the opening of the bile duct to facilitate stone removal and improve biliary drainage. This is one of the most commonly performed therapeutic ERCP procedures.

 

Bile Duct Stone Extraction

 

Using specialized balloons, baskets, and lithotripsy devices, stones can be safely removed from the bile duct. Even large or difficult stones can often be treated endoscopically without surgery.

 

Biliary Stenting

 

Plastic and self-expandable metal stents are used to relieve bile duct obstruction caused by benign disease or cancer. Stenting rapidly improves jaundice, itching, infection, and liver function.

 

Cholangioscopy-Guided Interventions

 

Direct visualization of the bile ducts allows targeted biopsies, accurate assessment of indeterminate strictures, and treatment of difficult stones using advanced lithotripsy techniques.

 

Management of Bile Leaks

 

Bile leaks may occur following gallbladder surgery, liver surgery, or trauma. ERCP with stent placement often provides definitive treatment without the need for repeat surgery.

 

Pancreatic Duct Therapy

 

Advanced ERCP techniques allow treatment of pancreatic duct stones, strictures, leaks, and selected complications of chronic pancreatitis.