ERCP (Endoscopic Retrograde Cholangiopancreatography) is a diagnostic and therapeutic endoscopic procedure
used to evaluate and treat conditions of the bile duct and pancreatic duct.
It combines endoscopic access with contrast imaging to assess ductal abnormalities
and, when required, perform endoscopic treatment during the same session.
What is ERCP?
ERCP is performed by advancing an endoscope through the mouth to the duodenum,
where the bile duct and pancreatic duct open.
Contrast imaging is then used to visualize the ducts and identify abnormalities.
In addition to diagnostic evaluation, ERCP can be used to perform
therapeutic procedures such as stone removal, drainage, sphincterotomy, or stent placement.
Conditions that may require ERCP
- Bile duct stones or suspected obstruction
- Jaundice due to bile duct narrowing or blockage
- Cholangitis or recurrent biliary infection
- Pancreatic duct abnormalities
- Biliary or pancreatic strictures
Indication is determined based on symptoms, imaging findings, and overall clinical condition.
Advanced ductal evaluation with SpyGlass DS
In some cases, standard ERCP contrast imaging alone may not provide sufficient information
about a bile duct lesion or difficult stone.
For selected patients, direct intraductal visualization with
SpyGlass DS cholangioscopy
may be used during ERCP to allow closer evaluation, targeted biopsy,
or more precise assessment of complex biliary disease.
How ERCP is performed
The procedure is performed using specialized endoscopic equipment with appropriate monitoring.
Sedation may be used depending on the clinical situation.
When indicated, treatment such as sphincterotomy, stone extraction,
drainage, or stent placement may be performed during the same session.
The approach is selected based on duct anatomy, disease severity, and patient factors.
After the procedure
Patients are monitored after the procedure for complications
and to confirm clinical stability.
Further management, including follow-up or additional treatment,
is determined based on the findings.
Frequently asked question
What is the difference between ERCP and SpyGlass?
ERCP is the general endoscopic procedure used to access and evaluate the bile duct and pancreatic duct.
SpyGlass DS is a specialized cholangioscopy system that can be used during ERCP
when direct visualization inside the bile duct is required.
SpyGlass is not used in every ERCP procedure. Its use depends on the imaging findings and clinical purpose.
Appointment
Appointments are required in principle.
A referral letter from another medical institution is recommended but not mandatory.
For appointment requests and language support, please see the
Gastroenterology page.