Endoscopy is a diagnostic procedure used to diagnose diseases of the digestive tract. A long flexible optic fiber with a camera and a light source at the tip is inserted through the mouth. This transmits images to a television monitor which helps the gastroenterologist to view the digestive tract from inside. During endoscopy, if surgical tools are introduced through the endoscope for taking tissue samples or to treat certain diseases of the biliary and pancreatic ducts, the procedure is called interventional endoscopy.

​

The interventional endoscopy procedures are broadly classified into:

​

Endoscopic Ultrasound

Endoscopic ultrasound utilizes endoscope and high frequency sound waves to diagnose the abnormalities in digestive tract. In this procedure, an echoendoscope, a special device that has an ultrasound probe on the tip, is used to obtain the images of internal organs of the digestive tract. It is used to take biopsy of the tumors, cysts or lymph nodes through a small needle in the endoscope (fine needle aspiration) and to give injection into the nerves of the celiac plexus using imaging, when narcotics cannot provide relief from intense pain in pancreatic cancer or chronic pancreatitis.

​

Endoscopic Retrograde Cholangio-Pancreatography

In endoscopic retrograde cholangiopancreatography (ERCP), once the endoscope reaches the papilla, the place where the pancreas and bile ducts meet, a thin tube will be inserted through the endoscope and a dye is injected into the ducts. X-ray images are taken to diagnose any problem related to the ducts. In case a problem is detected, the doctor may give treatment at the same time. It could be used for:

​

• Stone removal

​

• Manometry and Sphincterotomy: Sphincter is a cylindrical muscle functioning similar to one way valve regulating the flow of bile and digestive juices from the bile and pancreatic duct into the small intestine. It sometimes becomes hard and becomes narrow. This causes the backup of digestive juices and a strong upper abdominal pain. The pressure is measured at the sphincter using manometry while doing ERCP. If doctor finds that the pressure is high, the sphincter is enlarged using electrically heated wire in ERCP.

​

• Biopsy

​

• Balloon Dilatation: Due to cancer, gallstones, inflammation or scar tissue narrowing of the pancreatic or bile duct, ducts may occur. A balloon is inflated inside the narrow portion of these ducts to open them through ERCP.

​​

• Stenting: A small plastic or metal tube is left inside the pancreatic or bile duct through ERCP to open the narrow area in them.