Endoscopic retrograde cholangio pancreatography (ERCP)

Normal anatomy

The stomach leads to the first part of the small intestine, also called the duodenum. The common bile duct carries bile from the liver to the duodenum, and enters the duodenum a few centimeters beyond the stomach.

Review Date: 07/20/01
Reviewed By: A.D.A.M. Medical Illustration Team

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Adam makes no representation or warranty regarding the accuracy, reliability, completeness, currentness, or timeliness of the content, text or graphics. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Indication

Gallstones usually form in the gallbladder. Gallstones sometimes pass from the gallbladder into the common bile duct, and block the flow of bile into the duodenum. This can result in serious illness. Additionally, tumors of the pancreas and duodenum can block the bile duct, also preventing the flow of bile into the duodenum.

Review Date: 07/20/01
Reviewed By: A.D.A.M. Medical Illustration Team

Procedure, part 1

ERCP is a technique in which an endoscope, with a camera on its end, is passed down the esophagus, through the stomach, and into the duodenum. The entrance of the common bile duct into the duodenum can be viewed through the endoscope. Next, the surgeon can pass a special instrument on the end of the endoscope into the common bile duct as it enters the duodenum. Dye is injected through this instrument into the common bile duct; this allows for the visualization of gallstones by X-ray.

Review Date: 07/20/01
Reviewed By: A.D.A.M. Medical Illustration Team

Procedure, part 2

If gallstones are present in the common bile duct, the surgeon can perfom a sphincterotomy. A small incision is made through the endoscope, which enlarges the opening of the common bile duct into the duodenum. The stones can then pass through.

Review Date: 07/20/01
Reviewed By: A.D.A.M. Medical Illustration Team

Procedure, part 3

If a tumor is present and constricting the bile duct, a plastic or metal stent can be placed into the bile duct, thus holding it open, and allowing bile to pass through.

Review Date: 07/20/01
Reviewed By: A.D.A.M. Medical Illustration Team