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Advanced Biliary & Pancreatic Care
ERCP & Biliary Services
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a specialised procedure combining endoscopy and X-ray to diagnose and treat conditions of the bile ducts and pancreatic duct. Dr Kabiye is one of the few surgeons in the Eastern Caribbean with dedicated ERCP expertise.
What is ERCP?
ERCP uses a flexible camera (duodenoscope) passed through the mouth into the small intestine. A thin tube is then guided into the bile duct or pancreatic duct, and dye is injected under X-ray guidance to visualise the ducts.
Crucially, ERCP is not just a diagnostic tool — most procedures include treatment at the same sitting. A stone can be removed, a stricture dilated, or a stent placed, all without open surgery.
ERCP at a Glance
Duration45–90 minutes
AnaesthesiaDeep sedation or general anaesthesia
Hospital stayUsually same-day; overnight if complex
Recovery1–3 days rest at home
Success rate> 90% for bile duct stones
Conditions We Treat
ERCP treats a range of conditions affecting the bile duct, gallbladder, and pancreatic duct.
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Choledocholithiasis
Stones trapped in the common bile duct causing jaundice, pain, or cholangitis. ERCP with sphincterotomy and stone extraction is the first-line treatment.
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Acute Cholangitis
Bacterial infection of the bile duct causing fever, jaundice, and right upper quadrant pain. Emergency biliary drainage via ERCP is often life-saving.
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Biliary Strictures
Narrowing of the bile duct due to post-operative scarring, chronic pancreatitis, or malignancy. A stent is placed to restore bile flow and relieve jaundice.
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Primary Sclerosing Cholangitis
Progressive inflammatory narrowing of the bile ducts. ERCP with balloon dilation and stenting provides palliation and symptom relief.
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Post-operative Bile Leak
Bile leakage after cholecystectomy or liver surgery. ERCP with sphincterotomy ± stenting seals most leaks without the need for reoperation.
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Pancreatic Duct Disease
Strictures or stones in the pancreatic duct causing chronic pancreatitis pain. ERCP can drain the duct, decompress it, and reduce pain episodes.
ERCP Procedures We Perform
Sphincterotomy
A small cut in the sphincter of Oddi (the muscle at the opening of the bile duct) to allow stones to pass and drainage to occur. The foundation of most ERCP procedures.
Stone Extraction
Using a retrieval balloon or basket passed through the scope, bile duct stones are caught and removed. Success rate exceeds 90% for most stones. Very large stones may require mechanical or laser lithotripsy first.
Biliary Stenting
A plastic or self-expanding metal stent is inserted to keep the bile duct open in cases of stricture, malignant obstruction, or bile leak. Relieves jaundice, itching, and infection rapidly.
Balloon Dilation
A balloon is inflated within the bile duct to widen a narrowed segment — used for benign strictures or as an adjunct to stone removal.
Nasobiliary Drain
A small tube left in the bile duct and exiting through the nose for temporary external bile drainage — used in severe cholangitis when definitive treatment cannot be completed in one session.
Tissue Sampling (Brush Cytology / Biopsy)
Cells or tissue are taken from within the bile duct to test for malignancy. Important when a stricture is of uncertain cause.
Risks & Benefits
Benefits
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Treats bile duct stones without open or laparoscopic surgery
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Relieves jaundice, cholangitis, and bile leak in a single session
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Avoids the need for surgical exploration of the bile duct
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Same-day procedure in most cases
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Provides tissue diagnosis when malignancy is suspected
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Bridge to definitive surgery when the patient is unfit for immediate operation
Risks
Post-ERCP Pancreatitis (3–5%)
Inflammation of the pancreas — the most common complication. Usually mild and self-limiting with fluids and rest; rarely severe.
Bleeding (~1%)
Occurs at the sphincterotomy site. Most episodes stop spontaneously or are controlled endoscopically.
Perforation (<1%)
Rarely, the endoscope can perforate the duodenum or bile duct. May require surgical repair.
Cholangitis / Infection (~1%)
Bile duct infection can occur if bile drainage is incomplete. Preventable with antibiotics and adequate drainage.
Failed procedure (~5–10%)
Difficult anatomy (previous surgery, tight stricture) can prevent successful duct cannulation. Alternative approaches are then considered.
Why Amise Medical Services
Advanced ERCP Expertise in the Eastern Caribbean
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Fellowship-trained specialist
Dr Kabiye holds advanced fellowship training in therapeutic endoscopy and ERCP, with extensive experience in complex biliary cases.
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Full biliary surgery capability
As a consultant general surgeon, Dr Kabiye can provide the complete spectrum from ERCP to laparoscopic cholecystectomy to open biliary surgery when required.
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Urgent availability
Acute cholangitis and obstructive jaundice require rapid access. We prioritise urgent ERCP cases with same-week or emergency availability at Tapion Hospital.
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Coordinated care
We liaise directly with your referring physician, GI team, oncologist, or ICU to ensure seamless care. Procedure reports are sent on the day.
Need an urgent ERCP assessment?
Call or WhatsApp our Tapion office directly. For GP and specialist referrals, please use our online referral portal.