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ERCP and Endoscopic Sphincterotomy

Interventional endoscopy combining endoscopic visualization of the biliary and pancreatic ducts with cutting of the sphincter of Oddi.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is ERCP and Endoscopic Sphincterotomy?

Endoscopic retrograde cholangiopancreatography (ERCP) is an interventional endoscopic technique in which a duodenoscope is advanced to the second part of the duodenum, and contrast is injected through a catheter at the sphincter of Oddi to visualize and treat the biliary and pancreatic ducts.

Endoscopic sphincterotomy (ES) is the cutting of the sphincter of Oddi using a specialized catheter called a sphincterotome combined with electrocautery. By widening the papillary opening, sphincterotomy facilitates interventional procedures such as removal of bile-duct stones and stent placement.

Indications include choledocholithiasis (bile-duct stones), biliary strictures, ampullary tumors, pancreas divisum, sphincter of Oddi dysfunction, postoperative biliary leaks, type I papillary stenosis, and selected pancreatic ductal disorders. Pancreatitis, bleeding, perforation, and cholangitis are potential complications.

Symptoms

Choledocholithiasis (bile-duct stones)
Obstructive jaundice
Cholangitis
Biliary pancreatitis
Pancreatic ductal stricture
Postoperative bile leak
Ampullary tumor

Risk Factors

Post-ERCP pancreatitis (3-5% risk)
Young patient (higher pancreatitis risk)
Female sex
Difficult cannulation
Pancreatic-duct instrumentation
Coagulopathy
Significant cardiopulmonary disease (sedation risk)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Jaundice and dark urine
  • Fever with abdominal pain (Charcot triad of cholangitis)
  • Bile drainage after gallbladder surgery
  • Suspected bile-duct stones
  • Recurrent biliary pancreatitis
  • Referral for endoscopic evaluation

Treatment Methods

01
Preoperative MRCP for biliary roadmapping
02
Duodenoscope advancement to the papilla under sedation
03
Cannulation and contrast injection (cholangiography)
04
Sphincterotomy performed with a sphincterotome
05
Stone extraction (balloon, basket catheters)
06
Biliary stent placement when indicated
07
Post-ERCP pancreatitis prophylaxis (rectal indomethacin, pancreatic stent)

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.