Global Treatment Services Pvt. Ltd.

Global Treatment Services

Applications of ERCP in Cancer Treatments


ERCP is primarily used as a therapeutic procedure for treatment of diseases of

  • Bile duct

    • extraction of bile duct stones by balloon/basket (balloon/basket extraction)
    • by crushing large bile stones and retrieving them (mechanical lithotripsy)
    • relieving jaundice due to bile duct narrowing by dilating passage with balloon (balloon dilation)
    • treatment of bile duct infection (cholangitis) by draining pus by cutting open bile duct opening (biliary sphincterotomy) and placing stents /catheter in bile duct for free drainage of bile into duodenum ( plastic stent/ENBD placement)
    • stopping leakage of bile in bile duct injuries as a result of trauma and surgery
    • metallic stent placement for relief of itcing and jaundice in bile duct, pancreatic, gallbladder cancers (metallic stent placement)
  • Pancreas

    • relief of pain in chronic pancreatitis
    • by removal of pancreatic duct stones
    • dilating the narrowed pancreatic duct
    • placing of stents to facilitate drainage of infected fluid collection in pancreatitis (Pseudocyst drainage)

How is ERCP performed?

ERCP combines the use of X-rays and an endoscope, which is a long, flexible, lighted tube. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on X-rays.

For the procedure, you will lie on your left side on an examining table in an X-ray room. You will be given medication to help numb the back of your throat and a sedative to help you relax during the examination. You will swallow the endoscope, and the physician will then guide the scope through your oesophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At this time, you will be turned to lie flat on your stomach, and the physician will pass a small plastic tube through the scope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on X-rays. X-rays are taken as soon as the dye is injected.

Radiation Therapy for Cancer

Radiation therapy uses high-energy radiation to kill cancer cells by damaging their DNA directly or create charged particles (free radicals) within the cells that can in turn damage the DNA. X-rays, gamma rays, and charged particles are types of radiation used for cancer treatment. The radiation used for cancer treatment may come from a machine outside the body (external radiotherapy), or it may come from radioactive material placed in the body near Tumour cells (brachytherapy) or injected into the bloodstream (I131 for thyroid cancers). A patient may receive radiation therapy before, during, or after surgery, depending on the type of cancer being treated. The type of radiation therapy may vary of the size of the Tumour, and location of the Tumour.

Intensity Modulated Radiotherapy uses hundreds of tiny radiation beam-shaping devices, called collimators, to deliver a single dose of radiation and modulating different doses to different areas of the Tumour. Intensity guided Radiotherapy using repeat imaging CT and PET scans to reduce dose to normal tissues and enhance dose to specific areas of Tumour. Stereotactic radiosurgery (SRS) can deliver one or more high doses of radiation to a small Tumour by using accurate image-guided Tumour targeting and patient positioning systems. Therefore, a high dose of radiation can be given without excess damage to normal tissue. Electron beams are also used to irradiate superficial tumors such as on skin while protons beams are shown to have fewer side effects than normal photons in treating deeper tissues. Hyperthermia has also been used in conjunction with radiation to improve the treatment outcomes in several cancers.