Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic Retrograde Cholangiopancreatography, or ERCP, is a specialized technique used to study the ducts (drainage routes into the bowel) of the gallbladder, pancreas, and liver. The ones that drain the liver and gallbladder are called bile or biliary ducts, while the pancreatic duct drains the pancreas. The bile and pancreatic ducts join just before they drain into the upper bowel, this opening is called the papilla.

During an ERCP, an endoscope is used which is a thin, flexible tube that allows the doctor to see inside your bowel. The endoscope will pass through your mouth, oesophagus and stomach into the duodenum (first part of the small intestine). After seeing the common opening ducts from the liver and pancreas, the doctor will pass a narrow plastic tube called a catheter through the endoscope into the ducts.
A contrast dye will be injected into the pancreatic or biliary ducts and x-rays will be taken.

Various procedures can be performed using special instruments passed through the scope. These include enlarging the opening of the bile or pancreatic duct with a small cut, removal of gallstones from the bile duct or insertion of a small plastic tube to help drain the bile into the bowel.

The time taken for the procedure may be increased if additional treatments are required. The specialist will explain if any of these are considered likely before the ERCP.

If there is an unexpected abnormality, these procedures may be performed without prior explanation.