An ERCP (endoscopic retrograde cholangiopancreatography) is a minimally invasive method of evaluating the health and function of the ducts that drain the pancreas, liver, and gallbladder into the bowels. The drainage route leading from the pancreas is called the pancreatic duct. Those leading from the liver and gallbladder are called the biliary or bile ducts.
At Oceana Gastroenterology, we perform therapeutic ERCP to evaluate and treat issues affecting these areas of the body.
During the ERCP, Dr. M. Mazen Jamal will guide a thin, flexible tube (endoscope) from your mouth through the upper gastrointestinal (GI) tract – to the first part of the small intestine (duodenum). A catheter is then delivered through the endoscope and into the duct openings, and a contrast dye is injected into the area, so it shows up more clearly on real-time X-ray imaging for proper evaluation.
Therapies performed during an ERCP include:
- Removal of bile duct stones. This is the most common treatment performed during an ERCP. Bile duct stones can lead to obstruction and infection. When bile ducts are blocked, bile can build up in the liver and lead to a yellowing of the skin (jaundice). A gallstone that gets stuck in a duct can lead to pancreatitis, which causes symptoms of severe abdominal pain, nausea, and vomiting.
- Stenting for benign or malignant obstruction of the bile duct. In this procedure, a small flexible tube is used to hold open the bile duct after removal of the obstructing mass. Tiny instruments access the area via the endoscope during the ERCP.
ERCP education videos in Spanish
Therapeutic ERCP FAQs
An endoscopy involves inserting a flexible tube (with camera and light) through the mouth, esophagus and into the small intestine while a patient is IV-sedated. It is used to look for any tissue abnormalities within the upper GI tract (from esophagus to the upper end of the small intestine) and in some cases treat them on the spot, with miniature tools passed through the tube.
An endoscopic retrograde cholangiopancreatography (ERCP) is basically the same procedure – but it is specifically used to examine the pancreatic and/or biliary ducts.
Bile duct blockage or obstruction is a common reason an ERCP is conducted.
A blockage of the bile ducts may occur due to a number of problems, including gallstones, inflammation, scarring, tumors, even the presence of a certain type of parasitic flatworm (flukes).
Bile is an alkaline fluid produced by the liver and stored in the gallbladder; it is periodically released into the intestines to aid digestion of fat.
If the bile ducts become blocked, bile builds up in the liver, causing jaundice (yellowing of the skin and eyes), dark urine, and itchiness.
During the ERCP, a stent may be placed in the duct if the cause of obstruction is a narrowing or stricture of the duct. Balloon dilation may be used to widen duct walls. If the blockage is caused by gallstones, they will be removed.
Because an ERCP can irritate and cause inflammation of the pancreas, it is generally recommended only when some type of therapy or treatment is expected to be necessary.
Unsure if your symptoms indicate a problem with the liver, gallbladder, pancreas or the ducts that drain them? Dr. M. Mazen Jamal and the knowledgeable staff at Oceana Gastroenterology Associates can help. Contact us today to schedule an appointment – just call (951) 934-0505 or use our convenient appointment request form.