ERCP in Sharjah

What is ERCP?

ERCP stands for endoscopic retrograde cholangiopancreatography. Bile is made in the liver, stored in the gallbladder and carried to the small intestine through the bile duct. The pancreatic duct joins it at a small opening in the wall of the duodenum, called the papilla. When a stone, narrowing or growth blocks this drainage system, bile backs up, and the result can be jaundice, pain or infection.

During ERCP, a flexible endoscope passes through the mouth and stomach to the duodenum. This scope looks sideways rather than straight ahead, so it can face the papilla directly. A fine tube is guided into the duct, a dye that shows up on X-ray is injected, and the X-ray pictures reveal the shape of the ducts and the position of any stone or narrowing. Treatment then happens in the same session.

Because ERCP is a treatment rather than a first test, it follows a clear diagnosis. At Dar Al Kamal Hospital, Sharjah, the gastroenterologist assesses your symptoms, blood tests and scans, decides whether ERCP is the right step, and arranges it, either at the hospital or, where required, at a centre that provides it.

Who needs it

ERCP is used when a blockage in the bile or pancreatic duct needs treating. The most common reasons are:

• A gallstone that has slipped out of the gallbladder into the bile duct
• A narrowing of the bile duct that needs a stent to keep bile flowing
• A bile duct infection linked to a blockage, called cholangitis
• Gallstone pancreatitis where a stone is still lodged in the duct
• A leak of bile after gallbladder surgery

The decision usually starts with blood tests showing a raised bilirubin or liver enzymes, and an ultrasound that shows a widened bile duct. An MRI of the ducts, called MRCP, often confirms whether a stone is present, and it does so without any instrument entering the body. The choice of scan is explained on the abdominal imaging page. ERCP is then reserved for people who need treatment, which keeps its risks for those who benefit.

In the UAE, gallstones are closely linked to obesity, diabetes and rapid weight loss, including after weight-loss surgery, so a duct stone is a common reason for the procedure here. Pancreatitis care is covered on the pancreatitis treatment page, and liver causes of jaundice on the liver disease treatment page.

What happens

ERCP is carried out under deep sedation or a general anaesthetic, given by an anaesthesia team. You can read about this on the anaesthesia for endoscopy and sedation for procedures pages. You usually lie on your front or left side, which gives the clearest X-ray view of the ducts.

Once the scope reaches the papilla, the doctor may make a small cut in the muscle around the opening, called a sphincterotomy. This widens the exit so stones can come out. Stones are then drawn into the intestine with a small balloon or basket and pass naturally with the stool. Larger stones may be crushed first.

When a narrowing is found, a stent, which is a short plastic or metal tube, is placed across it so bile can drain. Many plastic stents are temporary and are planned for removal or exchange at a later ERCP. If a narrowing looks unusual, brushings or small tissue samples are taken and sent to the laboratory.

Preparing for it

You will be asked to fast beforehand, and the timing is given to you with your appointment. Bring a list of every medicine you take. Tell the team about blood-thinning medicines, diabetes medicines, any allergy to X-ray dye or iodine, previous stomach surgery and any chance of pregnancy. Do not stop blood thinners on your own; your doctor advises whether and when to pause them.

Your blood clotting and kidney function are usually checked in advance. Arrange for an adult to take you home, because sedation affects judgement for the rest of the day. If ERCP is planned during Ramadan, discuss the timing, since fasting and medicine schedules need adjusting.

Afterwards

You recover in a monitored area until the sedation wears off, and some people stay in hospital for observation. A sore throat and a bloated feeling from the air used during the procedure are common and settle. You restart eating and drinking when the team advises, usually beginning with fluids. In the UAE heat, keeping well hydrated in the following days helps recovery.

If you have a stent, you leave with a date for its review, removal or exchange. Keep this date even if you feel well, and plan summer travel around it. When stones came from the gallbladder, removal of the gallbladder is often advised to prevent more stones, and this is arranged with General and Laparoscopic Surgery.

Contact the hospital if you have persistent vomiting, dark stools or increasing tummy discomfort after ERCP.

Go to the emergency department straight away if you have yellowing of the skin or eyes with fever and shivering, or severe pain in the upper tummy. These can signal infection in the bile duct or pancreatitis.

Cost and insurance

ERCP is a specialised procedure, and most UAE insurance plans require pre-approval before it is booked. The approval usually covers the procedure, sedation or anaesthesia, and any stent placed. Where ERCP is arranged at another centre, cover is confirmed with that centre as well. Dar Al Kamal Hospital, Sharjah can help you check your cover on 06 599 7777.