ERCP in Nagpur

When disorders of the bile duct or pancreas demand precise diagnosis and immediate treatment, ERCP in Nagpur offers a highly advanced, minimally invasive solution.

Under the care of Dr. Amin Siddiqui, Consultant Gastroenterologist, Hepatologist and Interventional Endoscopist, ERCP is performed with a strong emphasis on safety, accuracy, and therapeutic effectiveness. The unit manages a large volume of ERCP procedures annually, reflecting both experience and trust.

ERCP (Endoscopic Retrograde Cholangiopancreatography) allows direct access to the biliary and pancreatic ductal system using endoscopic and fluoroscopic guidance. Unlike routine imaging tests, ERCP enables real-time diagnosis and treatment in a single procedure, often eliminating the need for surgery.

During the procedure, a flexible endoscope is gently passed through the mouth into the duodenum. High-resolution imaging helps identify ductal abnormalities, while specialized instruments allow immediate intervention such as stone removal, stent placement, stricture dilation, or tissue sampling.

ERCP in Nagpur is commonly advised for patients with jaundice, abnormal liver function tests, bile duct obstruction, unexplained pancreatitis, or suspected pancreaticobiliary disease, where accurate intervention is crucial.

Diagnosis

ERCP plays a critical role in identifying the cause of complex hepatobiliary and pancreatic conditions, including:

• Yellowing of eyes or skin (jaundice) with dark urine

• Persistently raised liver enzymes or bilirubin

• Bile duct blockage detected on ultrasound, CT scan, or MRCP

• Recurrent or unexplained pancreatitis

• Abnormal findings in prior imaging studies

• Persistent or unexplained upper abdominal pain

• Biliary infections such as cholangitis

• Evaluation and monitoring of pancreatic duct disorders

Through ERCP, conditions such as ductal stones, strictures, tumors, abnormal dilatation, and anatomical variations can be accurately identified. If suspicious tissue is seen, targeted biopsies can be taken during the same procedure for definitive diagnosis.

Cholangiography

ERCP provides direct visualization of the bile ducts using contrast imaging, making it especially valuable in patients with altered or post-surgical anatomy. This allows precise assessment of obstructions, stones, and strictures that may not be fully defined on other scans.

Manometry

When clinically indicated, manometry performed during ERCP evaluates sphincter of Oddi function, helping differentiate functional obstruction from mechanical blockage. This ensures that only patients who truly benefit undergo therapeutic intervention.

Treatment

ERCP in Nagpur is widely recognized as a therapeutic procedure, offering definitive treatment for multiple conditions, including:

• Removal of bile duct stones (choledocholithiasis)

• Extraction of large or impacted stones using advanced fragmentation techniques

• Dilation of narrowed bile ducts with placement of plastic or metallic stents

• Management of sphincter of Oddi dysfunction

• Control of bleeding from ampullary ulcers or vascular lesions

• Removal of pancreatic duct stones

• Palliative relief of obstructive biliary or pancreatic malignancies using stents

• Endoscopic control of bleeding tumors using electrocoagulation, laser therapy, or injection techniques

• Endoscopic removal of ampullary polyps and early tumors (ampullectomy), avoiding major surgery

Interventions

Dr. Amin Siddiqui performs a full spectrum of advanced ERCP-guided interventions, including:

Sphincterotomy
A controlled incision of the sphincter of Oddi to improve bile drainage and allow safe stone extraction.

Endoscopic Papillary Balloon Dilation (EPBD)
Balloon-based dilation used in selected cases to treat biliary narrowing.

CRE (Controlled Radial Expansion) Balloon Dilatation
Precise dilation of strictures using pressure-controlled balloons for optimal safety.

Mechanical Lithotripsy
Fragmentation of large bile duct stones that cannot be removed intact.

Endoscopic Biliary Stent Placement
Placement of plastic or metal stents to bypass obstruction and restore bile flow.

Ampullectomy
Endoscopic removal of ampullary polyps or tumors, performed en-bloc or piecemeal, often eliminating the need for surgery.

SEMS (Self-Expanding Metal Stent) Placement
Long-term stenting for unresectable malignant obstruction, providing durable symptom relief.

Cholangioscopy with SpyGlass System
Direct visualization of bile ducts, enabling targeted treatment of difficult stones and precise evaluation of indeterminate strictures.

Preventive & Surveillance Applications

Bile Duct Stone Surveillance
Bile duct stones are common in Asian populations. Surveillance ERCP is recommended in selected post-cholecystectomy patients and those with recurrent pancreatitis to enable early detection and endoscopic treatment before complications develop.

Surveillance in Primary Sclerosing Cholangitis (PSC)
Patients with long-standing PSC are at increased risk of cholangiocarcinoma. ERCP with tissue sampling and stricture management plays a vital role in early detection and ongoing monitoring.

Early Identification of Biliary Strictures
Timely detection and treatment of strictures helps prevent recurrent infections, prolonged jaundice, and progression to biliary cirrhosis.

Management of Post-operative Biliary Complications
Bile leaks or duct injuries following surgery can often be managed endoscopically with stent placement, avoiding repeat operations.