This test (abbreviated “ERCP”) is
an endoscopic approach to evaluate the bile duct and pancreas.
Commonly performed to remove stones from the bile duct, or to
place a tube (called a stent) into the bile duct or pancreas,
this test is the most complicated of the endoscopic procedures.
After you are positioned lying on your stomach, you are given IV
medication to induce gentle sleep. A special scope is then advanced
through your mouth to the first part of the small intestine.
Once there, the opening to the bile duct and pancreas is found.
It looks like a little volcano – a little mound with a tiny opening
in it. The doctor will then attempt to carefully manipulate a
thin plastic tube through the scope and into the opening.
Either the bile duct or the pancreas duct may be entered, but t
he doctor will guide the tube into the one which has the
problem needing to be addressed. Not all people’s anatomy
will allow the ducts to be entered, but success rates are
close to 90%. Once entered, dye is injected and an x-ray
is taken to see the configuration of the duct. If a stone
is present then a small cut is made to enlarge the opening,
and the stone is removed. Sometime there is a narrowing in
the duct, and a stent can be placed through it to encourage
proper fluid flows. Although safe, pancreatitis can occur from this test.