Therapeutic ERCP

Your hepatologist may recommend a therapeutic ERCP to treat suspected problems of the liver, pancreas, gallbladder, or bile ducts.

Common reasons for performing a therapeutic ERCP include: 

• gallstones in the bile or pancreas duct  
• pancreatitis (a swollen or damaged pancreas)   
• tumour in the pancreas, gallbladder, or liver 
• infection

A therapeutic ERCP is sometimes performed alongside a sphincterotomy. This involves making a small cut in a part of the digestive system called the ‘papilla of Vater’ to enlarge the opening of the bile duct and/or pancreatic duct. This is done to improve the drainage or to remove stones in the ducts.  

Your consultant will discuss with you how you can prepare. You may be asked to avoid eating and drinking for a few hours before the procedure. 

An ERCP takes about one hour. You can choose to have it under sedation or general anaesthetic.

Your hepatologist will place the endoscope in the back of your mouth, before guiding it gently down to your stomach and small intestine. A special dye, which shows up on X-rays, is injected through the endoscope.

The combination of video image from the endoscope and X-rays will provide your hepatologist with a detailed picture of how well your liver, pancreas, gallbladder, and bile ducts are working.

Your doctor can also use small tools passed through the endoscope to open blocked ducts, remove stones or tumours, or insert a stent (a small tube that holds open blocked ducts).   

After a therapeutic ERCP, you will need to rest in hospital for a few hours, and possibly overnight. You may experience some bloating or nausea for a short time. You might also have a slightly sore throat when the anaesthetic wears off, which can last a day or two.