Gallstone Treatment – ERCP
Also known as: endoscopic retrograde cholangiopancreatography (ERCP), gallstone endoscopy
Endoscopic retrograde cholangiopancreatography (ERCP) is a specialised procedure used primarily to treat problems in the bile ducts (such as removing gallstones or clearing blockages); it can also sometimes treat problems in the pancreatic ducts. Because ERCP carries some risks, non-invasive tests such as MRCP or endoscopic ultrasound are usually performed first to confirm the presence of stones.
What are gallstones?
Gallstones are solid deposits that form in the gallbladder or bile ducts. Many gallstones are harmless and cause no symptoms, but if they block the flow of bile, they can cause pain due to the buildup of pressure and inflammation. If untreated, bile duct obstruction can progress to complications such as infection (cholangitis), pancreatitis, or, in severe cases, sepsis.
What is gallstone treatment?
One of the most common treatments for gallstones in the bile ducts is ERCP. Endoscopic retrograde cholangiopancreatography is a procedure which uses a flexible camera passed through the mouth into the intestine to diagnose and treat issues in the biliary system and pancreatic ducts. ERCP allows doctors to visualise, diagnose, and treat blockages or stones. ERCP only removes stones from the bile ducts. If gallstones remain in the gallbladder, surgery (laparoscopic cholecystectomy) is usually recommended later to prevent new blockages.
Understanding the bile duct
The bile duct is a vital part of the digestive system. This small tube carries bile, a yellow-green fluid produced by the liver and stored in the gallbladder, into the small intestine, where it helps break down fats from the foods you eat. When the bile duct becomes blocked or narrowed, it can disrupt the flow of bile, leading to serious complications such as biliary colic, acute pancreatitis, and persistent abdominal pain. These blockages can be caused by gallstones, inflammation, or scarring, and may result in symptoms that require prompt medical attention.
Role of pancreatic ducts
The pancreatic ducts play a crucial role in the digestive system by transporting pancreatic juice from the pancreas to the small intestine. Pancreatic juice contains enzymes that aid in the digestion of proteins, fats, and carbohydrates. When the pancreatic ducts become blocked or narrowed, often due to gallstones or inflammation, it can lead to serious complications like acute pancreatitis and severe abdominal pain.
The bile ducts and pancreatic ducts work closely together to deliver digestive fluids to the small intestine, so any problem in one can affect the other and disrupt the entire digestive process.
Symptoms
Gallstones may cause sudden, intense pain in the upper right abdomen, which can sometimes spread to the shoulder or back. This pain is called biliary colic and often happens after fatty meals. Other symptoms that may indicate the need for urgent treatment include fever, yellowing of the skin (jaundice), persistent nausea and vomiting, or severe pain that doesn’t improve.
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Initial consultation
Your doctor will arrange tests, such as an abdominal ultrasound or blood tests, to check for gallstones and any potential complications. Abdominal ultrasound is a standard first imaging test; however, if stones or other abnormalities are suspected in the bile duct, more advanced imaging, such as endoscopic ultrasound, may be recommended. Endoscopic ultrasound uses a small ultrasound device at the tip of the endoscope to provide detailed images. It can detect more minor or subtle abnormalities that a standard abdominal ultrasound may miss. If stones are suspected in the bile duct, ERCP may be recommended.
Preparing for treatment
You’ll usually need to avoid food and drink for several hours before ERCP. Most likely, you’ll be given deep sedation to keep you relaxed and comfortable. In some cases, general anaesthesia may be used for higher-risk patients or more complex procedures. Before the procedure, you will be asked to sign a consent form to confirm your understanding and agreement to the treatment.
During treatment
The ERCP procedure involves the doctor passing a thin flexible camera through your mouth, down the oesophagus and stomach, and into the small intestine. Through this, fine instruments, including a small hollow tube (catheter), can be used to inject dye for X-rays, locate gallstones, and remove them. Stones may be taken out using a small basket or balloon, or broken into smaller pieces to help them pass naturally. Sometimes the bile duct opening is widened (sphincterotomy) to make removal easier. If needed, a small brush may be used during the procedure to collect a tissue sample from the bile or pancreatic ducts. These tissue samples are then sent to a laboratory for analysis.
In some cases, gallbladder removal (laparoscopic cholecystectomy) is performed as a separate procedure, often days or weeks after ERCP, to prevent new stones from forming.
After treatment
Immediate post-treatment care
You’ll be monitored for a few hours afterwards. A mild sore throat or bloating is common and usually settles quickly. You’ll typically be able to drink and eat light food the same day. During monitoring, staff will watch for any signs of complications, such as infection, to ensure prompt management if needed.
You’ll need someone to take you home afterwards, and you should avoid driving, alcohol, or making important decisions for 24 hours because of sedation.
Long-term recovery
Most people return to normal activities within a couple of days. Your doctor will explain whether you may also require gallbladder surgery later to prevent stones from forming again, as ERCP only treats stones in the bile ducts, not the gallbladder itself.
Possible complications
While ERCP is generally considered safe, it is essential to be aware of possible complications. Some patients may experience mild side effects such as a sore throat, abdominal pain, or bloating after the procedure. More serious complications, though rare, can include infection, pancreatitis (inflammation of the pancreas), bleeding, or perforation of the bile or pancreatic ducts. The risk of complications may be higher in patients with certain preexisting conditions or when more complex therapeutic procedures are performed. It is essential to discuss all potential risks and benefits with your doctor before undergoing ERCP, and to seek immediate medical attention if you experience intensifying pain, fever, or other concerning symptoms after the procedure.
Appointment and Treatment Plan
Initial Consultation
Your doctor arranges tests such as an abdominal ultrasound or blood tests, and if stones are suspected in the bile duct, more advanced imaging or ERCP may be recommended.
Pre-treatment Preparation
You avoid food and drink for several hours, receive deep sedation or sometimes general anaesthesia, and sign a consent form before the procedure.
Treatment
A flexible camera is passed through your mouth into the small intestine, dye is injected for X-rays, and gallstones are located and removed or broken up; sometimes the duct opening is widened or a tissue sample is taken.
Immediate Post-treatment Care
You are monitored for a few hours, may feel mild throat soreness or bloating, can usually eat and drink the same day, and must avoid driving, alcohol, or important decisions for 24 hours.
Long-term Recovery
Most people resume normal activities within a couple of days, and your doctor may recommend gallbladder removal later since ERCP only treats stones in the bile ducts.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
We offer 3 ways to pay for your treatment
We exist to take the stress out of private healthcare.
Our payment options are designed to offer you easy access to our treatments and services. You can choose to pay on the day, spread the cost, or use your private medical insurance.
Our patient services team will guide you through the process, providing clear costs and support throughout your course of treatment so you can focus on the thing that matters most – your health.
Whether you pay in advance, spread the cost, or use your private medical insurance, rest assured you will be receiving exceptional care 365 days a year.
Pay in Advance
Even if you do not have medical insurance, you can still get quick and comprehensive access to private medical care.
We provide transparent pricing from your initial consultation to the completion of your treatment so you know where you stand, every step of the way.
We accept all major debit and credit cards, as well as Apple Pay for UK residents. Please note that we do not accept cash or cheques.
Spread the cost monthly
Paying for your treatment at One Stop Healthcare can be spread monthly from 12 to 60 months, rather than paying in one go.
With an upfront 10% deposit paid, via our Financial partner Chrysalis Finance, we offer various flexible terms to enable you to spread the cost, including 12-months at 0% APR. Click here to find out more.
Monthly payments need to be linked to a One Stop Healthcare treatment over £385 and is subject to a 14-day ‘cooling-off’ period before any treatment can start.
Your on-going payments will be made directly between Chrysalis and yourself. It’s that simple.
Pay using PMI
We are recognised by all major health insurance companies and with our extensive range of services, there are lots of benefits to using your insurance with us. Our patient services team is here to answer any questions you may have about using your private health insurance with us.
Please bring along your policy details including your scheme details, membership or policy number, expiry date and confirmation of eligibility to claim (i.e. your authorisation number). If you do not have these details with you, we will require payment from you on the day. Patients are liable for any amounts not settled by their insurer.
FAQs
No. ERCP treats stones in the bile ducts using a camera passed through the mouth. It does not remove the gallbladder. Sometimes both treatments are needed – ERCP for bile duct stones, and gallbladder removal to prevent new stones.
ERCP clears bile duct stones in about 85-95% of cases. Most people feel better quickly, though a small number may need a repeat procedure.
ERCP is generally safe, but complications can include inflammation of the pancreas (pancreatitis), infection, bleeding, or, rarely, a small tear in the intestine, the bile duct or the pancreatic duct. Most complications are mild, but some can be serious and may require hospital treatment.
Most people go home the same day. You can usually return to normal activities within a couple of days. A sore throat, bloating, or mild discomfort are typical and short-lived.
In most cases, yes. ERCP clears stones from the bile duct, but if your gallbladder still contains stones, doctors usually recommend removing it later to prevent new blockages.
Yes, stones can sometimes recur if the gallbladder is not removed, as it may continue to produce stones. Your doctor will advise whether surgery is recommended in your case.
ERCP offers significant benefits for patients with problems in the bile and pancreatic ducts. As a minimally invasive procedure, ERCP allows doctors to both diagnose and treat conditions such as gallstones, bile duct stones, and blockages in a single session. This therapeutic procedure can alleviate symptoms of biliary colic, address complications such as acute pancreatitis, and restore normal function to the bile and pancreatic ducts. The ability to treat complications during the same procedure as diagnosis makes ERCP an efficient and effective option for managing a wide range of biliary and pancreatic conditions.