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Endoscopic Retrograde Cholangiopancreatography (ERCP) Treatment Information
At IU Health, we deliver leading edge therapeutic options on a daily basis.
Procedures that use endoscopic retrograde cholangiopancreatography include but are not limited to:
- Sphincterotomy. Your physician may cut the muscular sphincter of your bile duct or pancreatic duct to aid in a variety of treatments. To expand the opening, a small incision is made with an electrical current that cauterizes tissues. A sphincterotomy aids in bile duct stone removal, stent or drainage tube placement, stricture dilation and tissue sampling.
- Stone extraction. After a sphincterotomy, your physician can remove a bile duct stone with a special basket or use an inflatable balloon to sweep out the duct. Stones can also be removed from the pancreatic ducts, but the procedure is more complex.
- Mechanical lithotripsy. Larger stones may need to be crushed before a doctor can remove them. After being captured in a basket, the stones are broken into small pieces that can then be carried out of the body.
- Stricture dilation. A narrow or partially blocked bile or pancreatic duct can be opened with hydrostatic balloon dilation during an ERCP procedure. When inflated, the balloon stretches and expands the duct. Your physician can also achieve dilation with a graduated catheter that is passed over a guide wire.
- Stent placement. Once a blocked or narrowed duct is widened, your physician can place a stent (a small plastic or metal tube) in the duct to keep it open. This can help with duct drainage.
- Drainage. If attempts at stone removal are not successful, your doctor may use a nasobiliary drainage tube. An endoscope is used to place this long tube in your bile duct and thread it out through your nose. After placement, you will remain in the hospital for a few days for monitoring.
- Photodynamic therapy. ERCP can be used to deliver palliative photodynamic therapy to patients with cholangiocarcinoma that cannot be removed.
- SpyGlass procedures. This new technique allows your physician to place a scope into your bile ducts to obtain direct views of your tissues rather than relying on images taken during a regular ERCP. SpyGlass enables targeted biopsies and electrohydraulic lithotripsy under direct visualization.
- Biliary stricture management. If you have benign or malignant blockages in your bile ducts, your physician will monitor and treat those obstructions with medicines and interventions, including stenting.
- Management of Sphincter of Oddi dysfunction. This round muscle controls the flow of bile and pancreatic fluid into your small intestine to aid in digestion. When the sphincter does not open properly, the digestive liquids back up and cause you severe abdominal pain. Medicines can help treat this condition. Sometimes a sphincterotomy is needed.
Endoscopic Retrograde Cholangiopancreatography (ERCP) Locations & Physicians
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Endoscopic Retrograde Cholangiopancreatography (ERCP) Support Services
Learn more about ERCP treatments at these websites:
A Sampling of Endoscopic Retrograde Cholangiopancreatography (ERCP) Support Services
Indiana University School of Medicine Gastroenterology ERCP Website
This site offers in-depth information for patients about endoscopic retrograde cholangiopancreatography (ERCP), including links to other resources.
IU Division of Gastroenterology and Hepatology
This website provides patient preparation information about endoscopic retrograde cholangiopancreatography and other procedures.
American Society for Gastrointestinal Endoscopy
The patient section of this group’s website includes detailed information about many conditions and treatments such as ERCP.