ERCP for Pancreatitis

Endoscopic retrograde cholangiopancreatography (ERCP) can be used to diagnose and treat conditions involving the bile ducts, pancreas, and gallbladder. ERCP is particularly useful for instances where treatment can be administered during the initial diagnostic procedure.

Treating Pancreatitis with ERCP

ERCP for pancreatitis is used when the condition is caused by a blocked or narrowed bile duct. Blockages may be caused by gallstones, muddy bile, or other obstructions. ERCP is commonly used to treat both chronic and acute pancreatitis.Chronic pancreatitis is ongoing and may last for years. Acute pancreatitis occurs suddenly and may be accompanied by severe complications.

Stone Detection and Removal

ERCP for pancreatitis can be used to detect and remove gallstones that contributed to the development of the condition. ERCP for pancreatitis may detect gallstones that were undetectable using other diagnostic imaging methods such as computed tomography (CT) or ultrasound.

Gallstones can be removed during ERCP using a technique called endoscopic sphincterotomy. During endoscopic sphincterotomy, a small incision is made in the sphincter of Oddi. The sphincter of Oddi is the ring of muscles that controls the flow of bile and pancreatic juices. The stone can then be removed through the bile ducts using a specialized catheter.

Pseudocyst Drainage

ERCP for pancreatitis may be used to drain pseudocysts that develop from acute or chronic pancreatitis. A pseudocyst is a collection of fluid contained by a layer of tissue. Pseudocysts differ from true cysts in that the surrounding tissue is different. Drainage of pseudocysts is important to the patient’s outcome. If a pseudocyst ruptures, it may cause hemorrhaging or infection.

Stent Placement

Stent placement may be used in the presence of strictures, or narrowed bile ducts. A stent is a narrow, plastic tube that is placed internally. The stent opens narrow ducts and ensures the proper drainage of bile and pancreatic fluid.

Controversy Surrounding ERCP for Pancreatitis

ERCP for pancreatitis is a controversial procedure. While it may be the optimal treatment for certain cases, ERCP can cause severe complications. Additionally, ERCP is known to cause pancreatitis in cases where pancreatitis did not previously exist.

Many medical professionals and researchers argue that ERCP for pancreatitis may aggravate the condition. Additionally, ERCP for pancreatitis poses the risk of introducing bacteria into the patient’s pancreas. This can worsen pancreatitis and cause infection.

Safety during ERCP

Since ERCP for pancreatitis is a delicate procedure, patients should ensure that their physician is experienced and knowledgeable. Studies suggest that ERCP complications are significantly reduced when the procedure is performed safely by a competent medical professional.


Fiocca, Fausto, et al. “ERCP and acute pancreatitis.” European Review for Medical and Pharmacological Sciences. 6. (2002): 13-17. Print.

Kozarek, Richard. “Role of ERCP in acute pancreatitis.”Gastrointestinal Endoscopy. 56.6 (2002): S231-S236. Web. 4 Jul. 2013. <>.

Ulrich II, Charles, and Stephen Martin. “ERCP and Pancreatic Disease.” The National Pancreas Foundation. The National Pancreas Foundation, 8 Apr 2010. Web. 4 Jul 2013. <>.