ERCP

The procedure is performed by using a long, flexible, viewing instrument (a duodenoscope) about the diameter of a pen. The duodenoscope can be directed and moved around the many bends of the stomach and duodenum. The modern duodenoscope uses a thin fiber-optic bundle to transmit light to the tip of the endoscope, and a thin wire with a chip also at the tip of the endoscope to transmit digital video images to a TV screen. The duodenoscope is inserted through the mouth, through the back of the throat, down the food pipe (esophagus), through the stomach and into the duodenum. Once the papilla of Vater is identified, a small plastic catheter (cannula) is passed through an open channel of the endoscope into the opening of the papilla, and into the bile ducts and/or the pancreatic duct.

Contrast material (dye) is then injected and X-rays are taken of the bile ducts and the pancreatic duct. Another open channel in the endoscope also allows other instruments to be passed through it in order to perform biopsies, to insert plastic or metal stents or tubing to relieve obstruction of the bile ducts or pancreatic duct caused by cancer or scarring, and to perform incisions by using electrocautery (electric heat).