{"id":542,"date":"2026-01-16T03:20:06","date_gmt":"2026-01-16T03:20:06","guid":{"rendered":"https:\/\/kishiwada.tokushukai.or.jp\/en\/?page_id=542"},"modified":"2026-04-27T03:03:48","modified_gmt":"2026-04-27T03:03:48","slug":"ercp","status":"publish","type":"page","link":"https:\/\/kishiwada.tokushukai.or.jp\/en\/departments\/gastroenterology\/ercp\/","title":{"rendered":"ERCP \u2014 Bile Duct &#038; Pancreatic Duct"},"content":{"rendered":"<section class=\"op-section disease\">\n<p>  <!-- Key takeaways --><\/p>\n<div class=\"disease-kpi\">\n<div class=\"disease-kpi__item\">\n<div class=\"disease-kpi__label\">What we do<\/div>\n<div class=\"disease-kpi__value\">\n        ERCP (Endoscopic Retrograde Cholangiopancreatography)\n      <\/div>\n<\/p><\/div>\n<div class=\"disease-kpi__item\">\n<div class=\"disease-kpi__label\">Target area<\/div>\n<div class=\"disease-kpi__value\">\n        Bile duct and pancreatic duct\n      <\/div>\n<\/p><\/div>\n<div class=\"disease-kpi__item\">\n<div class=\"disease-kpi__label\">Approach<\/div>\n<div class=\"disease-kpi__value\">\n        Endoscopic evaluation and treatment when indicated\n      <\/div>\n<\/p><\/div>\n<\/p><\/div>\n<p class=\"disease-lead\">\n    ERCP (Endoscopic Retrograde Cholangiopancreatography) is a diagnostic and therapeutic endoscopic procedure<br \/>\n    used to evaluate and treat conditions of the bile duct and pancreatic duct.<br \/>\n    It combines endoscopic access with contrast imaging to assess ductal abnormalities<br \/>\n    and, when required, perform endoscopic treatment during the same session.\n  <\/p>\n<div class=\"disease-rows\">\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>What is ERCP?<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p>\n          ERCP is performed by advancing an endoscope through the mouth to the duodenum,<br \/>\n          where the bile duct and pancreatic duct open.<br \/>\n          Contrast imaging is then used to visualize the ducts and identify abnormalities.\n        <\/p>\n<p>\n          In addition to diagnostic evaluation, ERCP can be used to perform<br \/>\n          therapeutic procedures such as stone removal, drainage, sphincterotomy, or stent placement.\n        <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Conditions that may require ERCP<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<ul>\n<li>Bile duct stones or suspected obstruction<\/li>\n<li>Jaundice due to bile duct narrowing or blockage<\/li>\n<li>Cholangitis or recurrent biliary infection<\/li>\n<li>Pancreatic duct abnormalities<\/li>\n<li>Biliary or pancreatic strictures<\/li>\n<\/ul>\n<p class=\"disease-muted\">\n          Indication is determined based on symptoms, imaging findings, and overall clinical condition.\n        <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Advanced ductal evaluation with SpyGlass DS<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p>\n          In some cases, standard ERCP contrast imaging alone may not provide sufficient information<br \/>\n          about a bile duct lesion or difficult stone.\n        <\/p>\n<p>\n          For selected patients, direct intraductal visualization with<br \/>\n          <a href=\"\/en\/departments\/gastroenterology\/spyglass\/\">SpyGlass DS cholangioscopy<\/a><br \/>\n          may be used during ERCP to allow closer evaluation, targeted biopsy,<br \/>\n          or more precise assessment of complex biliary disease.\n        <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>How ERCP is performed<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p>\n          The procedure is performed using specialized endoscopic equipment with appropriate monitoring.<br \/>\n          Sedation may be used depending on the clinical situation.\n        <\/p>\n<p>\n          When indicated, treatment such as sphincterotomy, stone extraction,<br \/>\n          drainage, or stent placement may be performed during the same session.\n        <\/p>\n<p class=\"disease-muted\">\n          The approach is selected based on duct anatomy, disease severity, and patient factors.\n        <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>After the procedure<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p>\n          Patients are monitored after the procedure for complications<br \/>\n          and to confirm clinical stability.\n        <\/p>\n<p>\n          Further management, including follow-up or additional treatment,<br \/>\n          is determined based on the findings.\n        <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Frequently asked question<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<h3>What is the difference between ERCP and SpyGlass?<\/h3>\n<p>\n          ERCP is the general endoscopic procedure used to access and evaluate the bile duct and pancreatic duct.<br \/>\n          SpyGlass DS is a specialized cholangioscopy system that can be used during ERCP<br \/>\n          when direct visualization inside the bile duct is required.\n        <\/p>\n<p class=\"disease-muted\">\n          SpyGlass is not used in every ERCP procedure. Its use depends on the imaging findings and clinical purpose.\n        <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Appointment<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p>\n          Appointments are required in principle.<br \/>\n          A referral letter from another medical institution is recommended but not mandatory.\n        <\/p>\n<p class=\"disease-muted\">\n          For appointment requests and language support, please see the<br \/>\n          <a href=\"\/en\/departments\/gastroenterology\/#contact\">Gastroenterology<\/a> page.\n        <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>What we do ERCP (Endoscopic Retrograde Cholangiopancreatography) Target area Bile duct and pancreatic duct Approach Endoscopic evaluation and treatment when indicated 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 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":526,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-542","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 4.9.8 - aioseo.com -->\n\t<meta name=\"description\" content=\"ERCP is an endoscopic procedure used to evaluate and treat bile duct and pancreatic duct disorders, including stones, obstruction, infection, and strictures.\" \/>\n\t<meta name=\"robots\" content=\"max-image-preview:large\" \/>\n\t<link rel=\"canonical\" href=\"https:\/\/kishiwada.tokushukai.or.jp\/en\/departments\/gastroenterology\/ercp\/\" \/>\n\t<meta name=\"generator\" content=\"All in One SEO (AIOSEO) 4.9.8\" \/>\n\n\t\t<meta name=\"google-site-verification\" content=\"K2ktbgQNYZ4X2mTrERHdrH3PRAQUoJjsJgrsQbW0d_E\" \/>\n\t\t<meta 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