ERCP - Endoscopic Retrograde Cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized endoscopic procedure that combines endoscopy and radiology to visualize and treat conditions of the bile ducts and the pancreatic duct. A side-viewing endoscope (duodenoscope) is introduced through the mouth down to the duodenum, where a catheter is inserted into the common opening of the biliary and pancreatic ducts (the ampulla of Vater). Today, ERCP is used mainly for therapeutic purposes. It allows the removal of stones from the bile ducts (choledocholithiasis), the placement of biliary or pancreatic stents to relieve an obstruction, sphincterotomy (opening of the sphincter of Oddi) and the drainage of infected bile ducts (cholangitis). These minimally invasive procedures often avoid the need for open surgery. The injection of a contrast agent into the biliary and pancreatic ducts, combined with fluoroscopy (real-time X-ray imaging), makes it possible to map the biliary and pancreatic tree with great precision. This technique is essential for locating obstructions, guiding therapeutic procedures and verifying their effectiveness. At Clinique Pasteur in Tunis, ERCP is performed in a room equipped with a fluoroscopy C-arm by gastroenterologists specialized in interventional endoscopy. The examination is carried out under general anesthesia, with rigorous post-operative monitoring to prevent and detect any complication.