What's ERCP And Who Does It?

By: GI Alliance


Endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that allows a gastroenterologist to examine the pancreatic and bile ducts. ERCP is an essential tool in diagnosing pancreatic conditions, managing jaundice, and dealing with gallstones that migrate to the bile ducts. ERCP is best performed by a board-certified gastroenterologist, who will have the highest ability to perform the procedure, interpret the results, and act on the results. How ERCP Works ERCP-for-stuck-gallstonesERCP is a minimally invasive procedure that does not require abdominal incisions. During this procedure, a thin, flexible tube with a light and camera on the end is inserted through the mouth and into the stomach and duodenum, or the top part of the small intestine. Once in the duodenum, the doctor will be able to identify a small opening into the ducts, through which he inserts a thin tube (cannula). Finally, the doctor injects dye into the ducts through the cannula, and x-rays are taken. This provides an image of the system of ducts that connects the pancreas and liver to the intestines. If necessary, the doctor can take biopsies at the same time. Uses of ERCP ERCP is often used to diagnose people who have symptoms of diseases of the bile ducts or pancreas, especially if blood tests or other imaging tests gave inconclusive results. Symptoms that may indicate such problems include:
  • Abdominal pain
  • Jaundice
  • Weight loss
  • CT scan or ultrasound showing gallstones or a mass in the ducts, pancreas, or liver
ERCP can also be used to treat certain conditions. It can be used in conjunction with gallbladder surgery, and can successfully be used to remove bile duct stones in patients that develop jaundice, abdominal pain, nausea or vomiting from impacted stones. Tumors that block the ducts can be identified and treated by inserting an indwelling plastic tube to bypass the blockage. ERCP is useful in patients with pancreatic cancer or chronic pancreatitis causing narrowing of the bile ducts and jaundice, so the symptoms of jaundice, itching, nausea, etc. may be relieved. Who Performs ERCP? ERCP is most safe and effective when it is performed by a gastroenterologist who has extensive training and experience in the procedure. As with any procedure, there are certain side effects associated with ERCP, and having the most qualified doctor perform the procedure can minimize that risk. Additionally, having the procedure performed by a GI doctor at a full-service center means that any and all identified GI conditions can be treated by one doctor, in one place. This produces greater efficiency as well as continuity of care, both of which are associated with better care and better outcomes. If you have symptoms of a bile duct problem or a pancreatic problem, it is important to schedule a consultation with a trusted gastroenterologist. Dr. Andrew Nelson, one of the 17 board certified gastroenterologists at Gastroenterology Associates, specializes in ERCP and meets with patients who self-refer or are referred by their physician for the procedure. Schedule an appointment today!