Endoscopic examination of the biliary (gallbladder) and pancreatic ducts is a specialized procedure that allows visualization of the bile and pancreatic ducts using a combination of endoscopy and X-ray imaging. During the examination, a catheter is used to access the second part of the duodenum, known as Vater's ampulla, where the bile and pancreatic ducts converge. By using the catheter, the condition of both systems or either of them can be assessed, enabling the diagnosis of conditions such as gallstones, growths in the bile ducts or pancreas, and more. The procedure also has therapeutic benefits, as in most cases, it allows for the removal of stones from the main bile duct (not the gallbladder) and the clearance of obstructive blockages in the ducts, which could lead to infection and jaundice, through the placement of a special stent.
Possible complications of the examination include inflammation of the duodenum (3-5%) and much rarer occurrences of bleeding or perforation. This examination is of utmost importance in treating infections in the biliary system, removing stones before or after gallbladder surgery, and relieving obstructive jaundice caused by growths in the bile ducts or pancreas.
Preparation for the examination involves fasting for approximately 8 hours and discontinuing blood-thinning medications. The procedure is usually performed on an outpatient basis, allowing the patient to return home afterward. In some cases, the treatment may require hospitalization or a decision for further observation or additional treatment may be made after the examination.