Dr. Robert M. Webman is a veteran southern California gastroenterologist who provides care in both private practice and hospital settings. Robert M. Webman, MD’s experience includes upper gastrointestinal treatments, such as endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy.
Undertaken with radiography, the ERCP scope provides an accurate visualization of the pancreatic and bile ducts, which drain the pancreas and the liver. Primarily a therapeutic procedure, ERCP can be used to treat conditions such as chronic pancreatitis by removing painful duct stones. It is also employed in the removal of bile, stricture dilation, and in stent placement.
Sphincterotomy involves using a specialized catheter device to cut the muscle of the papilla, or the duct opening. The ERCP scope is vital in viewing this extremely small cut, which enables a number of duct treatments to proceed. In cases where bile duct stones need to be removed, the sphincterotomy enlarges the papilla to a point where the stones can be pulled into the bowel and removed. In cases of very large stones, they may need to be crushed into fragments within the duct, prior to removal.