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What is ERCP?

The ERCP procedure involves passing a flexible tube (endoscope) through the mouth, esophagus, and stomach into the first part of the small intestine (the duodenum) where the drainage opening for the bile and pancreatic ducts is located.  The doctor then passes a small plastic tube (catheter) through a channel in the endoscope and out into view in the duodenum and inserts it into this small opening.  A contrast solution (dye) is then injected through the catheter into the bile and pancreatic duct system(s), and x-rays are taken. These can be viewed immediately so that the doctor can make a diagnosis.


The doctor may take specimen samples for analysis if the x-rays (and any previous tests) suggest the possibility of cancer.  Tiny wire brushes are used to scrape the duct lining and retrieve cells for microscopic examination.  Small pinching biopsy forceps can be used to take larger pieces of tissue.  Bile or pancreatic juice can be retrieved and sent to the laboratory to check whether there is any infection or to look for disturbance of the normal digestive constituents.