ERCP | London Gastro Care

ERCP is a procedure that uses an endoscope and X-rays to look at your bile duct and pancreatic duct. ERCP can also be used to remove gallstones or take small samples of tissue for analysis (a biopsy).

What happens during ERCP

The endoscope also has a ‘side channel’ down which various tubes or instruments can pass. These can be manipulated by the doctor who can do various things. For example:

• Inject a dye into the bile and pancreatic ducts. X-ray pictures taken immediately after the injection of dye show up the detail of the ducts. This may show narrowing (stricture), stuck gallstones, tumors pressing on the ducts, etc.
• Take a small sample (biopsy) from the lining of the duodenum, stomach, or pancreatic or bile duct near the opening called the papilla. The biopsy sample can be looked at under the microscope to check for abnormal tissue and cells.
• If the X-rays show a gallstone stuck in the duct, the doctor can widen the opening of the papilla to let the stone out into the duodenum. A stone can be grabbed by a ‘basket’ or left to be passed out with the stools (feces).
• If the X-rays show a narrowing or blockage in the bile duct, the doctor can put a stent inside to open it wide. A stent is a small wire mesh or plastic tube. This then allows bile to drain into the duodenum in the normal way. You will not be aware of a stent, which can remain permanently in place.

The endoscope is gently pulled out when the procedure is finished. An ERCP can take anything from 30 minutes to over an hour, depending on what is done.