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Endoscopic Retrograde Cholangio-Pancreatography

Dr Fisher performs in excess of 250 ERCPs each year

In endoscopic retrograde cholangio-pancreatography (ERCP) once the endoscope reaches the papilla the place where the pancreas and bile ducts meet, a thin tube will be inserted through the endoscope and a dye is injected into the ducts. X-ray images are taken to diagnose any problem related to the ducts. In case a problem is detected the doctor may give treatment at the same time. It can be used for

  • Stone removal
  • Manometry and Sphincterotomy: Sphincter is a cylindrical muscle functioning similar to one way valve regulating the flow of bile and digestive juices from the bile and pancreatic duct into the small intestine. It sometimes becomes hard and becomes narrow. This causes the backup of digestive juices and a strong upper abdominal pain. The pressure is measured at the sphincter using manometry while doing ERCP. If doctor finds that the pressure is high the sphincter is enlarged using electrically heated wire in ERCP.
  • Biopsy
  • Balloon dilatation: Due to cancer, gallstones, inflammation or scar tissue narrowing of the pancreatic or bile duct ducts may occur. A balloon is inflated inside the narrow portion of these ducts to open them through ERCP.

Stenting: A small plastic or metal tube is left inside the pancreatic or bile duct through ERCP to open up the narrow area in them.

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