Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed for diagnostic or therapeutic indications.


Indications for diagnostic ERCP:

(1) diagnosis of possible tumor at the ampulla

(2) assessment of chronic pancreatitis

(3) diagnosis of possible pancreatic tumor

(4) biliary disease with jaundice or abnormal liver function tests

(5) a dilated biliary tree on ultrasonography


Indications for therapeutic ERCP:

(1) bile duct stones

(2) bile duct injury

(3) bile duct strictures due to tumor or scarring

(4) postcholecystectomy syndrome

(5) some cases of pancreatitis

(6) replacement of an obstructed ampullary stent


Indications for emergency ERCP:

(1) fulminant cholangitis due to obstructed bile duct, with drainage of bile and appropriate antibiotic therapy

(2) severe gallstone pancreatitis


Therapeutic uses for ERCP:

(1) biliary duct stone extraction or lithotripsy

(2) placement of stent

(3) endoscopic sphincterotomy of the sphincter of Oddi

(4) ampullary balloon dilatation

(5) nasobiliary tube drainage


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