What is ERCP?

Endoscopic Retrograde Cholangio-Pancreatoscopy (ERCP) is endoscopy of the bile duct and pancreas. At our Trust, this procedure is performed by Dr Fickling, Dr Bettany, Dr Gupta, and Dr Premchand.

The most common reason to perform an ERCP is to remove gallstones from the bile duct or to relieve a blockage of the bile duct by tumour.

The procedure

The procedure is performed with a special endoscope called a duodenoscope. In this instrument the operating channels open sideways to allow views and access to the ampulla, which is the opening of the bile and pancreas ducts in the duodenum.

Small instruments are passed down the working channel to allow access into the bile duct. These instruments can be used to open the lower end of the bile duct (sphincterotomy), remove stones or place metal and plastic stents.

In our Trust, we perform the full range of ERCP procedures. We have access to biliary manometry (pressure measurements of the bile duct) and Spyglass. Spyglass is a tiny endoscope that can be passed through the duodenoscope directly into the bile duct allowing targeted treatment and sampling of stones and strictures.

How long does it take?

ERCP takes between 20 to 45 minutes depending on the procedure being performed.

Pain relief

ERCP is usually performed with a combination of spray to numb the throat and intravenous pain killers and sedation.

After the procedure

If you are an outpatient you may be able to go home after the procedure (day case) but expect to be with us most of the day. Some patients may need to stay overnight. ERCP is a safe procedure - your doctor will speak to you about any possible complications that may occur.