Endoscopic Retrograde Cholangiopancreatography (ERCP) for Pancreas Disorders

Cincinnati Children’s is one of only a few pediatric medical centers in the country that offers endoscopic retrograde cholangiopancreatography (ERCP) by a pediatric endoscopist.

What is an ERCP?

This specialized procedure is used to diagnose and treat abnormalities in the pancreatic ducts. These abnormalities may be specific to the drainage duct or related to the pancreas organ itself.

Who is a candidate? Show

An ERCP can be performed on children of any age, including newborns and infants. The procedure is typically offered for patients with:

Acute recurrent pancreatitis
Chronic pancreatitis
Ductal injuries
Gallstone disease causing pancreatitis
Inflammatory disorders (specific to the pancreas)
Obstructive stones involving the pancreatic duct
Strictures within the duct
Abnormal ductal anatomy of the pancreas

What does an ERCP entail? Show

During an ERCP, the doctor uses a special endoscope (narrow, flexible tube) that is fitted with a video camera at the end of the scope. While the child is asleep, the tube is placed down the child’s upper digestive system. The doctor is able to view any stones, abnormal narrowing or blockages involving the ducts.

To treat these problems, the doctor slides tiny surgical tools through the endoscope, using video guidance to repair the delicate structures within and around the pancreatic duct.

Most ERCP procedures involve treating an abnormality, although the procedure is sometimes used for diagnosis only.

ERCP can take anywhere from 20 minutes to two hours, depending on the type of treatment needed.

Afterward, the doctor meets with families to talk about the procedure, discuss the treatment performed, review the endoscopic and fluoroscopic pictures and answer any questions. At that time, the doctor also will talk about anticipated recovery time and future plan of care, including the need for a possible repeat ERCP.

What is the recovery period like? Show

After an ERCP, most children are able to eat and drink normally soon after recovering from the sedation (anesthesia). Most children will stay in the hospital overnight for observation and will be allowed to go home the following day after making a full recovery.

A small percentage of children develop temporary complications. The most common is ERCP-related pancreatitis, a temporary inflammation of the pancreas. This can require a longer hospital stay of between two and five days to recover.

After the child is discharged home, he or she typically will return for a follow-up appointment to evaluate the effectiveness of the ERCP. In some cases, another ERCP procedure is needed to achieve the desired outcome.