Endoscopic retrograde cholangiopancreatography (ERCP) - Investigations and procedures

Endoscopic retrograde cholangiopancreatography (ERCP)

ERCP is used in the diagnosis and treatment of conditions of the biliary tract and pancreas, such as in obstructive jaundice or if obstruction of the pancreatic ducts is suspected. It provides more detailed information than an ultrasound scan. A sideviewing endoscope is passed into the duodenum and a radioopaque dye injected into the biliary and pancreatic systems by means of a cannula inserted into the papilla of Vater. This is followed by realtime radiography.

Further diagnostic and therapeutic manoeuvres:

·        Biopsy of periampullary tumours.

·        Sphincterotomy or balloon dilatation to allow gall-stone removal.

·        Dilatation of benign biliary strictures.

·        Insertion of stents to relieve obstructive jaundice. The rate of complications with a diagnostic ERCP is approximately 1%, but this rises with any therapeutic procedure. The most common complication is acute pancreatitis. Haemorrhage and perforation occur less commonly. Ascending cholangitis may be prevented by antibiotics, which are given prophylactically to all patients with possible biliary obstruction.