حصوات القناة الصفراوية

What is ERCP?

Endoscopic retrograde cholangiopancreatography combines endoscopy and fluoroscopy to diagnose and treat diseases of the biliary and pancreatic ducts. For choledocholithiasis (CBD stones), ERCP is the first-line treatment — no surgery required.

Why China?

• Cost: $2,500-$4,500 vs. $8,000-$20,000 in the US
• SpyGlass cholangioscopy: Direct visualization + laser lithotripsy for difficult stones
• High volume: Top centers perform 3,000+ ERCPs/year
• Advanced biliary drainage: EUS-guided hepaticogastrostomy for failed ERCP

Who is a candidate?

• Choledocholithiasis (CBD stones)
• Malignant biliary obstruction (stent placement)
• Post-cholecystectomy bile leak
• Cholangitis/acute gallstone pancreatitis
• Primary sclerosing cholangitis with dominant stricture

Outcomes

Stone clearance: 90-95% for standard stones, 75-85% for complex stones (may need SpyGlass/lithotripsy). Post-ERCP pancreatitis: 3-5% (reduced with rectal NSAID). Perforation: <1%.