Advanced Endoscopic Procedures Performed in the Hospital

Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP is a specialized procedure used to evaluate and treat problems involving the bile ducts, pancreas, liver, and gallbladder. It allows the physician to diagnose conditions such as strictures, gallstones, leaks from trauma or surgery, and certain cancers. ERCP combines endoscopy and X-ray technology to visualize the ducts that carry bile and pancreatic fluids into the digestive tract.

During the procedure, you will lie on your left side on a special X-ray table. You will receive medication to numb your throat and IV sedation to help you relax. The gastroenterologist inserts a long, flexible endoscope through the mouth, passing it through the esophagus and stomach into the duodenum. Once positioned at the opening of the bile and pancreatic ducts, a thin tube is used to inject contrast dye, making the ducts visible on X-ray.

If a gallstone or obstruction is found, instruments can be passed through the scope to remove the blockage or place a stent to widen a narrowed duct. Tissue samples (biopsies) may also be taken for further testing. ERCP lasts anywhere from 30 minutes to two hours. Afterward, you will remain in the hospital for one to two hours while sedation wears off. If therapeutic treatment is performed, such as stone removal, you may need to stay overnight for observation.

Because you will receive medication to help you relax, you will not be permitted to leave without someone who can drive you home. The sedative may affect coordination and alertness for several hours.

Endoscopic Ultrasound (EUS)

Endoscopic Ultrasound (EUS) is another advanced endoscopic procedure performed in the hospital to obtain detailed images of the digestive tract and nearby organs. By combining endoscopy with ultrasound technology, EUS allows for precise evaluation of the pancreas, liver, gallbladder, esophagus, stomach, rectum, and surrounding structures.

The procedure uses an endoscope with a small ultrasound transducer at its tip. When inserted through the mouth or rectum, EUS provides high-resolution images from inside the body, often with greater clarity than traditional external ultrasound. EUS is commonly used to evaluate unexplained abdominal pain, abnormal weight loss, esophageal or stomach lesions, pancreatic masses, rectal tumors, and benign growths of the upper GI tract.

Because the ultrasound probe is positioned close to the target organs, EUS produces exceptionally detailed images that help detect early stages of cancer, inflammation, cysts, or blockages. Your doctor may also use EUS to guide fine-needle aspiration (FNA) to collect tissue samples for diagnosis, when needed.