ERCP in Thailand

Bile ducts are tubes which transport bile from the liver to the gallbladder and duodenum. Pancreatic ducts are tubes which transport pancreatic juice from the pancreas to the duodenum. Small pancreatic ducts join to a main pancreatic duct. The common bile duct and main pancreatic duct join and empty into the duodenum.

ERCP is used to treat diseases and disorders of the bile and pancreatic ducts. If the doctor wants a diagnosis only, they usually opt for noninvasive tests such as magnetic resonance cholangiopancreatography (MRCP). This is a type of magnetic resonance imaging (MRI) that is safer and can also be used to diagnose various problems of the bile and pancreatic ducts.

• Infection
• Gallstones stuck in the common bile duct
• Acute and chronic pancreatitis
• Pancreatic pseudocysts
• Trauma of the bile or pancreatic ducts
• Tumors or cancer of the pancreas
• Tumors or cancer of the bile ducts

• The procedure can be performed at an outpatient center or hospital. It usually lasts between 1 to 2 hours. A sedative is given through an intravenous needle which is placed in your arm. The sedative will keep you relaxed during the procedure. You will be given a liquid anesthetic to gargle or spray at the back of your throat. This numbs the throat and prevents gagging as the procedure is performed. In some cases, general anesthesia is used.
• As you lie on the examination table the doctor feeds the endoscope carefully down your esophagus, through the stomach, and into the duodenum. A small camera at the endoscope’s end sends images to a monitor. The endoscope also pumps air into the duodenum and stomach making it easier to see.
• The openings of the bile and pancreatic ducts into the duodenum are located. A catheter is then placed through the endoscope and into the ducts. A contrast medium is them injected into the ducts through the catheter to make the ducts visible on X-rays. The doctor then uses fluoroscopy (an x-ray imaging technique) to examine the ducts and find blockages or narrowed areas.

• Remove or break up stones
• Open narrowed or blocked ducts
• Perform a biopsy or remove tumors in the ducts
• Insert stents to hold the ducts open