What is ERCP?

Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure whereby a side-viewing upper endoscope is guided into the first pat of the small intestine (duodenum), letting instrument to be passed into the bile duct and pancreatic ducts. These ducts are opacified by injection of a contrast medium, that can be seen radiologically, to help in a wide variety of therapeutic/diagnostic interventions. ERCP Procedure ERCP is a complex endoscopic procedure done by a gastroenterologist with specialized training. The advantage of this procedure is that it is minimally invasive to the biliary and pancreatic duct but yet pose a risk for serious complications. Indications for ERCP The National Institutes of Health has developed a statement regarding the indications for ERCP as follows in 2002: ERCP, magnetic resonance cholangiopancreatography (MRCP), and endoscopic ultrasonography (EUS) have comparable sensitivity and specificity in the diagnosis of choledocholithiasis (gallstone in the common bile duct). ERCP plus sphincterotomy with simultaneous stone removal is an important treatment option for choledocholithiasis patients with jaundice, imaging showing dilated common bile duct, acute pancreatitis, or cholangitis. In patients with pancreatic or biliary cancer, the principal advantage of ERCP is palliation of biliary obstruction when surgery is not elected. Tissue sampling/biopy for patients with pancreatic/biliary cancer not will to undergo surgery. ERCP is the most accurate approach for diagnosis of ampullary cancers. ERCP has no role in the diagnosis of acute pancreatitis unless there is biliary pancreatitis and early intervention can reduce mortality and morbidity. ERCP is generally not indicated in: Evaluation of abdominal pain of…

Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure whereby a side-viewing upper endoscope is guided into the first pat of the small intestine (duodenum), letting instrument to be passed into the bile duct and pancreatic ducts.

These ducts are opacified by injection of a contrast medium, that can be seen radiologically, to help in a wide variety of therapeutic/diagnostic interventions.

ERCP Procedure

ERCP is a complex endoscopic procedure done by a gastroenterologist with specialized training. The advantage of this procedure is that it is minimally invasive to the biliary and pancreatic duct but yet pose a risk for serious complications.

Indications for ERCP

The National Institutes of Health has developed a statement regarding the indications for ERCP as follows in 2002:

  • ERCP, magnetic resonance cholangiopancreatography (MRCP), and endoscopic ultrasonography (EUS) have comparable sensitivity and specificity in the diagnosis of choledocholithiasis (gallstone in the common bile duct).
  • ERCP plus sphincterotomy with simultaneous stone removal is an important treatment option for choledocholithiasis patients with jaundice, imaging showing dilated common bile duct, acute pancreatitis, or cholangitis.
  • In patients with pancreatic or biliary cancer, the principal advantage of ERCP is palliation of biliary obstruction when surgery is not elected.
  • Tissue sampling/biopy for patients with pancreatic/biliary cancer not will to undergo surgery.
  • ERCP is the most accurate approach for diagnosis of ampullary cancers.
  • ERCP has no role in the diagnosis of acute pancreatitis unless there is biliary pancreatitis and early intervention can reduce mortality and morbidity.

ERCP is generally not indicated in:

  • Evaluation of abdominal pain of obscure origin in the absence of objective findings that suggest biliary or pancreatic disease. Magnetic resonance cholangiopancreatography and EUS are safe diagnostic procedures that can obviate the need for ERCP.
  • Prior to laparoscopic cholecystectomy in the absence of signs of biliary obstruction.
  • Evaluation of suspected gallbladder disease without evidence of bile duct disease.
  • As further evaluation of proven pancreatic malignancy unless management will be altered.
Vikram Tarugu

Dr. Vikram Tarugu is an award-winning Gastroenterologist with board certification earned from both the “American Board of Internal Medicine” and the “American Board of Internal Medicine Sub-Specialty in Gastroenterology“. Currently practicing in West Palm Beach & Okeechobee, FL. Dr. Vikram Tarugu is a proficient medical professional specializing in the diagnosis and treatment of digestive health complications. With over 20 years of in-the-field experience, 2,000+ procedures conducted, and 4,000 patients treated; Dr. Vikram Tarugu has been recognized as one of the best GI doctors, not only in the state of Florida in which he practices, but nationwide.

Share
Published by

Recent Posts

Medical Marijuana for Gastrointestinal Problems

Need for Medical Marijuana The need to have medical marijuana for gastrointestinal problems arises when conventional medications fail to heal…

8 months ago

What is gastritis? How to diagnose gastritis

Gastritis is the inflammation of inner stomach lining. It is an abnormal condition in which the production of mucus and…

1 year ago

What are probiotics? Which is the best probiotic? How do you take them?

Definition Probiotics are the microorganisms that are beneficial for the deliberate manipulation of the intestinal micro flora. They are stated…

2 years ago

Hepatitis C Treatment and Management

Both acute and chronic hepatitis are caused by the Hepatitis C Virus known in short as HCV. Acute hepatitis rarely…

2 years ago

Rectal Bleeding Diagnosis, Management, and Treatment

Acute rectal bleeding, also known as lower gastrointestinal (GI) bleeding, is the loss of fresh blood from the colon. Blood…

2 years ago

Splenda, Ulcerative Colitis and Crohn’s Disease: Can Artificial Sweeteners Worsen Effects?

A recent study by Dr. Alex Rodriguez-Palacios, DVM, assistant professor of medicine at Case Western Reserve School of Medicine, indicates…

2 years ago