How these organs work together
Think of it as a small plumbing system. Bile from the liver and juice from the pancreas meet at a tiny opening called the papilla, in the first part of the small intestine (the duodenum). A stone, a narrowing or a growth anywhere along these tubes can back things up, causing pain, jaundice, infection or pancreatitis.
Two endoscopic tools do most of the work here: endoscopic ultrasound (EUS) to see the area in fine detail and take samples, and ERCP to treat, for example by removing stones or placing stents.
Conditions
Bile duct stones
Stones in the common bile duct, removed by ERCP.
Read more →Gallstones
When stones need treatment, and when they can be left alone.
Read more →Jaundice and bile duct blockage
Finding the cause and opening the duct.
Read more →Acute pancreatitis
Sudden inflammation of the pancreas, and preventing the next attack.
Read more →Chronic pancreatitis
Long-term pain, stones in the pancreas, diabetes and digestion.
Read more →Pseudocysts and walled-off necrosis
Fluid collections after pancreatitis, drained endoscopically.
Read more →Pancreatic cysts
Cysts found by chance: which to watch, which to sample.
Read more →Pancreatic and bile duct tumours
Diagnosis, staging and relieving blockage.
Read more →Symptoms that point to this area
- Pain in the upper belly, often spreading to the back
- Yellow eyes or skin, dark urine, pale stools or itching
- Fever with shivering together with jaundice
- Oily, floating, foul-smelling stools and weight loss
- New diabetes after 50 with weight loss
Tests we commonly use
| Test | What it shows |
|---|---|
| Ultrasound abdomen | Gallstones, a widened bile duct, liver changes. A good first test. |
| Liver function tests, lipase/amylase | Blocked bile flow; inflamed pancreas. |
| CT scan | Pancreatitis severity, collections, masses. |
| MRCP (MRI of the ducts) | Detailed map of the bile and pancreatic ducts without a scope. |
| EUS | Very close view of the pancreas and ducts; small stones; biopsies. |