ERCP

Endoscopic retrograde cholangiopancreatography is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is primarily performed by highly skilled and specialty trained gastroenterologists. Endoscopic retrograde cholangiopancreaticography (ERCP) is a procedure for treatment of biliary and pancreatic diseases
ERCP is performed by the oral route after sedation. During ERCP, bile duct and pancreatic ducts are evaluated after injection of contrast agent, and various therapeutic procedures can be performed
During ERCP stones can be removed form CBD or pancreatic duct and stents can be placed in CBD for treatment of jaundice and in MPD for pain relief

Indications of ERCP are

• Removal of common bile duct or pancreatic duct stones
• Removal of worm form CBD or pancreatic duct
• Jaundice due to obstruction of bile duct by compression due to lymph node or cancer
• Sphincter of oddi dysfunction
• Biliary ascites due to leakage of bile from bile duct
• Stricture in common bile duct after surgery
• Chronic pancreatitis with stricture in the main pancreatic duct
• Pancreatic ascited because of pancreatic duct fluid leak
• Tumor of gall bladder, ampulla, pancreas and bile duct leading to common bile duct obstruction

ERCP is a safe procedure in expert hands, and is performed on day care basis, however serious complications like cholangitis, pancreatitis, perforation can occur in 1-3% of cases, which may require longer hospital stay