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Endoscopic retrograde cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is a surgical procedure used to diagnose and treat conditions of the biliary and pancreatic ductal system. We explain what happens during the procedure.


Endoscopic retrograde cholangiopancreatography (ERCP) is a surgical procedure which is used by surgeons to diagnose and treat conditions of the biliary and pancreatic ductal system.

There are numerous conditions which may be successfully treated with an ECRP and these include:

  • Gallstones (which may have travelled to the ductal system)
  • Pancreatitis (acute or chronic)
  • Infections
  • Certain types of tumours
  • Adhesions and scarring due to previous surgery in the area

At a pre-operative assessment clinic, our expert anaesthetists and nurses will conduct a full medical evaluation to ensure it is safe for you to undergo an ECRP.

Most ECRP procedures are performed under heavy sedation but some are performed under general anaesthesia depending on the exact circumstances. Your throat will be numbed using a spray or asking you to gargle a liquid. The procedure is performed in our ultra-clean operating theatres with the patient lying in a comfortable position.

Following this, an endoscope which is a flexible, tube with a camera and other specialised instruments fitted is passed down the throat, through the stomach in to the duodenum to visualise the biliary tree and pancreas. Specialised dye is injected in to the biliary tree and pancreas and a continuous x-ray (fluoroscopy) enables the surgical team to view the journey of the dye over time allowing an assessment of how the biliary and pancreatic ductal system is functioning.

A diagnosis will be made based on these findings and treated if possible during the same procedure. Treatments may include:

  • Removing or breaking up gallstones
  • Opening blocked and narrowed ducts
  • With collapsed ducts sometimes stents are used to keep them open
  • Tissue is taken from any masses found (biopsy)

In general, an ECRP procedure is an extremely safe way of surgeons evaluating and treating problems with the biliary and pancreatic ductal system. However, after an ECRP you may experience:

  • Nausea and fatigue (due to the effects of sedation or general anaesthetic)
  • Sore throat and difficulty swallowing
  • Bloated feeling (as air is pumped in to the stomach and duodenum for better visualization during the procedure)
  • Small tears can occur in the ductal system leading to a bleed
  • Irritation and inflammation to the pancreas (pancreatitis)

Once our experienced nurses and your surgical team have reviewed your observations, you will be discharged home to recover on the day of your surgery.

Specialists offering Endoscopic retrograde cholangiopancreatography (ERCP)

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Dr Mayur Kumar

Consultant Gastroenterologist

MBBS, MRCP( Gastroenterology)

Chelsfield Park Hospital 1 more The Sloane Hospital

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Dr Andrew Millar

Consultant Gastroenterologist & Hepatologist

BSc (Hons), MBBS, MD, FRCP

The Cavell Hospital 1 more The Kings Oak Hospital

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Dr Aymer Postgate

Consultant Gastroenterologist & General Physician

MC BS (Hons), BSc (Hons), MD, FRCP

Bishops Wood Hospital 1 more The Clementine Churchill Hospital

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