Endoscopic Retrograde Cholangiopancreatography (ERCP)


Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic procedure that utilizes X-rays and a technique known as upper gastrointestinal endoscopy to diagnose and potentially treat issues associated with the bile ducts.

Bile ducts are small tubes, including some inside the liver, that transport a digestive fluid called bile from the liver to the gallbladder and duodenum, which is the initial portion of the small intestine. Upper gastrointestinal endoscopy utilizes a thin, flexible camera called an endoscope to examine the upper GI tract. Passed down the patient’s throat, the endoscope allows the doctor to directly view and potentially treat issues inside the body, including problems in the pancreatic and bile ducts, without invasive surgery.    

Usually, physicians employ ERCP when the bile or pancreatic ducts have become constricted or blocked. Reasons for bile duct blockage can include:

How ERCP is Performed

ERCP is performed while the patient is sedated, and usually takes between one and two hours. With the patient lying on their back, an endoscopic specialist feeds the endoscope down the patient’s throat, through the stomach and into the duodenum. During the procedure, the endoscope usually pumps air into the stomach and duodenum to make them easier to see.

Once the end of the endoscope has reached the point where the pancreatic and bile ducts empty into the duodenum, a thin, flexible catheter is inserted through the endoscope until the tip of the tube is inside the ducts. The specialist then uses the catheter to introduce a special dye called “contrast medium” into the ducts.

This contrast medium, when used in conjunction with a special type of x-ray imaging called fluoroscopy, makes the ducts easier to see on x-rays. This allows physicians to easily see any blockages or strictures in the ducts and potentially discover their cause.

In addition to getting a clearer view of the blockage and its cause, ERCP can also sometimes be used to treat the blockage during the same procedure. Utilizing small tools passed through the endoscope, physicians can sometimes:

  • Open blocked bile ducts
  • Remove tumors or tissue that might be causing blockage
  • Collect tissue samples for biopsy
  • Insert tiny tubes called stents to hold ducts open
  • Break up or remove gallstones

Next-Generation Endoscopic Procedures at Hoag

Hoag’s commitment to advanced diagnostic techniques and less-invasive procedures is leading the way toward a future with shorter recovery times and less pain. Learn more about Hoag’s Advanced GI Lab in Newport Beach.

The Hoag GI Lab is a state-of-the-art center that offers a variety of technologically advanced equipment and highly trained staff and physicians. All physicians are board-certified in gastroenterology and many Hoag GI Lab staff are members of the Society of Gastroenterology Nursing and Associates and have specialty certification.