Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP

ERCP or endoscopic retrograde cholangiopancreatography is a procedure that can reveal blockage or narrowing in the pancreatic and bile ducts. These ducts carry digestive juice from your liver and pancreas to the intestines. An endoscope (small, flexible tube) is inserted into the mouth, and then through the esophagus and stomach to the top of the small intestine.  Then a smaller tube with dye is injected through the scope to make the bile ducts show up on an x-ray and visualize any abnormalities. An endoscopist will perform this procedure at a hospital or outpatient clinic. 

Why is an ERCP performed?

Your physician may decide you need an ERCP if you have an abnormal CT scan or ultrasound, inflammation (cholangitis), yellowing of the skin and eyes (jaundice), bile or pancreas duct stones, tumors or lesions in the pancreas, gallbladder or liver. Your physician will use an endoscope that goes down your throat into the stomach and the duodenum. Your physician will then inject dye that will show up on X-rays to see how well the ducts are working.

EGD vs ERCP

An ERCP is able to go farther; into your biliary ducts, while the EGD can only go to the first part of the upper GI tract.

ERCP may be used to:

  • Treat bile duct leaks
  • Stretch out narrow segments (biliary strictures)
  • Remove gallstones or tumors
  • Take tissue samples of tumors or lesions
  • Treat cholangitis (inflammation) and pancreatitis 
  • Drain blocked areas
  • Take tissue samples
SAGES Patient Information ERCP

Image courtesy of SAGES

References

Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). 2020. ERCP. https://www.sages.org/publications/patient-information/patient-information-for-ercp-endoscopic-retrograde-cholangio-pancreatography-from-sages/ 

Cleveland Clinic. 2023. ERCP. https://my.clevelandclinic.org/health/diagnostics/4951-ercp-endoscopic-retrograde-cholangiopancreatography