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   ercp_procedure_benefitsWhat Is ERCP?

Endoscopic retrograde cholangiopancreatography (ERCP) uses an endoscope, or thin, flexible tube, to create an image of the inside of the bile ducts (cholangitis), pancreatic duct, spleen, and lymph nodes.

In patients with biliary obstruction, cholangitis, or suspected pancreatic cancer, ERCP can assess for disease and guide treatment.

ERCP is performed as an outpatient procedure with sedation and anaesthesia, and it generally takes less than 2 hours.


The Benefits of ERCP Include:

-Viewing the inside of the bile ducts

-Confirming disease

-Providing a map for potential treatments

-Finding the source of a blockage

-Determining if a blockage is severe

-Determining the severity of a suspected cancer


-PET imaging



The Procedure

E.R.C.P is an acronym for Endoscopic Retrograde Cholangiopancreatography.

It is a medical procedure used by your doctor to diagnose liver conditions if liver function is compromised.

E.R.C.P. may be advised for diagnosing gallstones, treatments of certain pancreatic diseases, and managing some digestive disorders.

These types of conditions are difficult to diagnose without this type of endoscopic imaging.

A special tube is inserted into the mouth and throat, which is then expanded to reach past the stomach and into the pancreatic duct. The endoscope allows the doctor to view the inside of the ducts.

In a lot of cases this procedure is used to find the problem from the inside, taking pictures of the stomach for example.

The procedure also allows things to be inserted inside to help with any complications, such as the removal of stones from the gall bladder to help with pain.

ERCP has a lot of benefits, such as finding the problem from the inside, things being inserted to help alleviate the problem, and the benefits of a healthier intestine.



What Happens During the Procedure?

Endoplasmic reticulum cisternae (ER, or simply cisternae) are the spaces of the hepatocyte. They are further divided into rough and smooth ER.

The hepatocyte functions in the liver’s detoxification process and lipid metabolism, so any changes in the hepatocyte’s ER could affect these functions.

This can be seen in hepatocytes with steatosis and hepatocyte injury. Changes that occur in hepatocyte ER can lead to the development of chronic liver diseases like that seen in non-alcoholic fatty liver disease.

Ethology and pathogenesis of these changes in hepatocytes remain unknown. 

These changes in hepatocyte ER may be caused by an aggregation of Tau protein (α-synuclein) in hepatocyte ER.

This aggregation of Tau protein (α-synuclein) may be responsible for the changes in hepatocyte ER.

These changes in hepatocyte ER can be seen in hepatocytes with steatosis and hepatocyte injury.


How ERCP Works

ERCP is an endoscopic procedure that assesses and treats problems in the bile duct and pancreas. ERCP is endoscopic because we use a long, thin tube to examine and treat the patient.

An endoscope is a thin tube that is inserted into your mouth and end endows the viewer with a sight like no other.

Endoscopic video and light systems allow the viewer to see and diagnose problems and to treat them. ERCP is an imaging procedure that utilizes an endoscope to visualize the bile ducts of the gallbladder, pancreas, and duodenum sometimes.

The radiographer feeds the bile ducts over the end of the tube.

The radiographer may also inject contrast into the bile duct, which shows up on CSF so they can see the problem better. Sometimes the radiographer will need to remove stones, stones, or tumors to treat the patient.




Types of ERCP: 

Endoscopic Retrograde Cholangiopancreatography, or ERCP, is the use of an endoscope to treat various problems in the bile ducts and pancreas. There are two different types of ERCP.

The first type, called mechanical ERCP, uses insertion of an endoscope to mechanically clear an obstruction in the duct if it fails to do so naturally.

The second type, called chemical ERCP, involves injection of fluid into or around an obstruction in the duct.



Benefits of ERCP

The Procedure has many benefits, one being it provides a method of removing pancreatic stones.

It can also be used to diagnose pancreatitis, pancreatic cancer, and pancreatic trauma via the insertion of a small tube used to collect a sample of tissue from the pancreas.

ERCP can be the solution to many pancreatic diseases and is one of the most minimally invasive procedures available to treat these diseases.


How Long Does It Take?

ERCP is a surgical procedure where a probe is used to view and treat problems in the bile and pancreatic duct. It is usually done by sedation or general anaesthesia.

It takes forty-five minutes to an hour to complete the procedure.


How Safe Is the Procedure?

ERCP is one of those procedures that has been improving over the years, with physicians taking increasingly clearer and safer images of the small intestine and surrounding areas of the body.

Different types of doctors will have different procedures that their patients may need to get treatment for and/or diagnosed for.

The ERCP procedure itself, is something that can be done safely overall as long as there are no complications, or any sort of damage being done to other parts of the body inadvertently.

Overall, ERCP isn’t an overly complicated procedure if it’s performed by a highly trained physician, who can prepare you properly before they begin.


Is It Right for You

ERCP offers a different perspective other than a traditional endoscopy.

In patients that have a stricture or other obstruction in their bile duct, this test could be beneficial to evaluate the size of the stricture and the bile duct.

Without a strong foothold at the common bile duct, a surgical procedure to remove the obstruction might be needed to diagnose and treat the obstruction.

ERCP is a minimally invasive procedure. The patient can go home a few hours after the procedure. And it is an outpatient procedure.

Granted, this procedure may not be the best option for everyone, but if you have been diagnosed or suspect you have a stricture or other obstructions in your bile duct, then ERCP may be the exam for you. 

Who Should Not Be Referred for Procedure?

Patients with the following disorders should not be referred for this procedure:

  • During pregnancy
  • Unhealthy liver
  • Poor kidney function
  • Bleeding or clotting disorders




An ERCP is Used to Observe, Diagnose and Screen the:

  • Diseases of the gallbladder
  • Biliary system
  • Pancreas
  • Liver

In addition, ERCP can be used to treat problems in these parts of the digestive system.

Dr Deetlefs has admitting rights and performs endoscopies at both Mediclinic Milnerton and Life Vincent Pallotti Hospitals.

To learn more about the complexity of your gut and the opportunity for you to contribute to the scientific pursuit of gastrointestinal knowledge, visit our Cape Town office or visit our website.

We are gastroenterologist experts using patient-focused GI treatment and procedures in Cape Town.

If you haven’t been scheduled for a colonoscopy and want to get one, make an appointment now.


The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

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© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.