Learning that your child needs an endoscopic retrograde cholangiopancreatography (ERCP)or endoscopic ultrasound (EUS) can feel overwhelming. At Children's Wisconsin, we're here to answer your questions, explain what to expect and guide your family through every step of the process. Our pediatric specialists have specialized training and expertise in caring for children who need these procedures.

Whether your child needs a diagnosis or treatment, our team combines specialized expertise with advanced technology to provide expert care while minimizing discomfort and recovery time.

EUS is a specialized, minimally invasive procedure that combines endoscopy with high-resolution ultrasound to create detailed images of the digestive tract and nearby organs, including the pancreas, bile ducts, liver and surrounding lymph nodes.

What Happens During an EUS?

Your child will receive general anesthesia and sleep comfortably throughout the procedure. The doctor passes a thin, flexible endoscope through the mouth into the stomach and small intestine or, in some cases, through the rectum. An ultrasound probe at the tip of the endoscope creates detailed images of nearby organs and tissues. When needed, specialized needles or other instruments can be used to obtain tissue samples or perform treatment.

What Can My Child’s Doctor Do During an EUS?

• Evaluate the pancreas, bile ducts and surrounding organs
• Detect small gallstones, bile duct stones or biliary sludge
• Diagnose acute or chronic pancreatitis
• Identify pancreatic cysts, tumors or other abnormal growths
• Evaluate enlarged lymph nodes
• Perform fine-needle aspiration (FNA) or fine-needle biopsy (FNB)
• Drain pancreatic fluid collections using EUS-guided cystogastrostomy when appropriate

What Should My Child Expect When Recovering From an EUS?

Most children go home the same day after recovering from general anesthesia. If a biopsy or therapeutic procedure is performed, or if additional monitoring is needed, your child may stay overnight.

ERCP is a specialized, minimally invasive procedure used to diagnose and treat conditions affecting the bile ducts, gallbladder and pancreas. It combines endoscopy with live X-ray imaging (fluoroscopy) to evaluate the bile and pancreatic ducts and often allows diagnosis and treatment during the same procedure.

What Happens During an ERCP?

Your child will receive general anesthesia and sleep comfortably throughout the procedure. A specialized endoscope (duodenoscope) is passed through the mouth into the first part of the small intestine. A small catheter is guided into the bile or pancreatic ducts, and contrast dye with live X-ray imaging helps identify narrowing, stones, leaks or other abnormalities. If treatment is needed, specialized instruments can be passed through the endoscope during the same procedure.

What Can My Child’s Doctor Do During an ERCP?

• Remove gallstones or bile duct stones
• Remove biliary sludge
• Perform a biliary or pancreatic sphincterotomy
• Stretch narrowed bile or pancreatic ducts (strictures)
• Place temporary stents
• Drain blocked bile ducts
• Treat bile duct leaks
• Obtain tissue samples (biopsies) or brushings

What Should My Child Expect When Recovering From an ERCP?

After the procedure, your child will recover from general anesthesia while being closely monitored. Depending on the procedure performed, your child may begin with a clear liquid diet before gradually returning to regular foods. Most children stay overnight in the hospital for observation before going home the following day.

• Acute, recurrent and chronic pancreatitis
• Gallstones and bile duct stones
• Bile duct narrowing (strictures)
• Choledochal cysts
• Pancreatic cysts and fluid collections
• Abnormal liver blood tests
• Bile duct or pancreatic duct injuries
• Gastrointestinal lesions requiring biopsy

Specialized Pediatric Expertise | Children's Wisconsin is one of the few pediatric centers in the Upper Midwest offering advanced diagnostic and therapeutic ERCP and EUS performed by a pediatric gastroenterologist with dedicated advanced endoscopy fellowship training. Our program is led by Diana Lerner, MD, who completed an additional year of advanced therapeutic endoscopy fellowship training at the University of Colorado Anschutz Medical Campus.

Advanced Diagnostic and Therapeutic Procedures | Our team offers advanced therapeutic interventions including stone extraction, sphincterotomy, stent placement, fine-needle aspiration (FNA), fine-needle biopsy (FNB) and EUS-guided cystogastrostomy when appropriate.

Nationally Recognized Pediatric Gastroenterology Program | U.S. News & World Report consistently ranks Children's Wisconsin's pediatric gastroenterology program among the nation's best.

Care Designed for Children | Our team specializes in caring for infants, children and teens using pediatric-specific equipment and techniques while tailoring care to each child's age and developmental needs.

Coordinated Care for Families | Our Access Center helps coordinate appointments, referrals, medical records and communication before your visit. Families traveling from outside the area may also be eligible for assistance with lodging, including the Ronald McDonald House and other nearby accommodations.