CPT® Code 43264

Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized medical procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the biliary and pancreatic ducts. This procedure is particularly focused on the removal of calculi, or stones, from these ducts. During an ERCP, a flexible endoscope is inserted through the patient's mouth, passing through the esophagus and stomach, and into the duodenum, which is the first part of the small intestine. The procedure targets the ampulla of Vater, where the pancreatic duct and common bile duct converge. By cannulating this area, healthcare professionals can inject contrast dye into the ducts, allowing for detailed imaging via X-rays to visualize any obstructions or abnormalities. The removal of stones or debris is a critical aspect of this procedure. Once the ducts are visualized, various techniques can be employed to extract the stones. This may involve the use of a balloon catheter, which is maneuvered past the stone, inflated, and then withdrawn to extract the stone. Alternatively, a basket extraction technique may be utilized, where a specialized device captures the stone and is then slowly retracted. In cases where stones cannot be removed intact, methods for destruction are also available, including mechanical crushing or the use of electrohydraulic or laser lithotripsy to fragment the stones for easier removal. Overall, ERCP is a vital procedure for managing conditions affecting the biliary and pancreatic systems, providing both diagnostic and therapeutic capabilities.