What is therapeutic endoscopy?

Therapeutic endoscopy is a way to diagnose and treat certain problems in the digestive tract, liver, bile ducts and pancreas without the need for traditional surgery or any cutting into the skin.

While your child is asleep (sedated), the doctor gently passes a long, flexible tube with a camera attached to it down their throat. This long tube, called an endoscope, passes through your child's mouth and stomach. The doctor uses the camera to look inside your child's body. The doctor can then diagnose and treat the problem using small instruments that are passed through the endoscope.

Therapeutic endoscopy is done while your child is sedated. Your child will not have any discomfort during the procedure. It may be done on an outpatient basis, or it may involve staying in the hospital overnight. This depends on your child's condition and the nature of the treatment.

What is ERCP?

Endoscopic retrograde cholangiopancreatography (ERCP) is a form of therapeutic endoscopy that combines the images from the camera with X-rays. It allows the doctor to see and treat through the endoscope any problems with the tubes that drain the liver, gallbladder or pancreas.

Why choose Seattle Children's?

We have the only pediatric ERCP and therapeutic endoscopy program in the Pacific Northwest. The program is led by Dr. Matthew Giefer, a specially trained pediatric endoscopist. Dr. Giefer is an expert in accurately diagnosing and managing the most complex gastrointestinal and pancreatic issues in kids.

Your child will be sedated (general anesthesia) during ERCP and any other therapeutic endoscopy procedure. All of our pediatric gastroenterologists and anesthesiologists are board-certified. This means they have completed extra training in the special needs of children and adolescents under sedation. This special training helps to ensure your child's safety and comfort during the procedure.

ERCP and therapeutic endoscopy are part of Seattle Children's Hospital's comprehensive Gastroenterology and Hepatology Program. The entire care team specializes in treating the unique needs of children and teens. We bring all the necessary specialists together: pediatric gastroenterologists, surgeons, rehabilitation physicians and dietitians.

We provide coordinated care to ensure that your child's treatment is comprehensive. Because we focus solely on children and adolescents, we understand that they have different needs than adults. We will partner with you to make sure your child or teen feels safe, understands what is happening and is able to be part of decisions about their care as appropriate to their age or developmental level. Child life specialists can work directly with you and your child to help relieve tension, express concerns or fears and feel more in control about the hospital experience.

Conditions We Treat

We treat children and adolescents with complications related to gallstone disease, chronic pancreatitis, abdominal trauma, liver transplantation, obesity and other conditions. For example, the tubes that drain your child's liver or pancreas may be blocked due to inflammation, gallstones or infection.

Services We Provide

We provide several forms of therapeutic endoscopy, including:

  • Endoscopic retrograde cholangiopancreatography (ERCP): The doctor uses images from the endoscope along with X-rays to look at the bile ducts, gallbladder, pancreas and the tubes that drain these organs. Small instruments passed through the endoscope allow the doctor to treat the problem without open surgery.
  • Balloon enteroscopy: This procedure allows the doctor to see much deeper into the small intestine and treat bleeding or narrowing, or remove foreign bodies, without surgery.

Who's on the team?

Dr. Matthew Giefer is a pediatric gastroenterologist and the director of the Therapeutic Endoscopy Program. He has extensive training in ERCP and other forms of therapeutic endoscopy.

Giefer works with a group of specialized endoscopy technicians and our board-certified pediatric anesthesiologists. He also works closely with other specialists from Anesthesia, Radiology, Gastroenterology and HepatologyPediatric General and Thoracic Surgery and Liver Transplantation to ensure that your child's care is coordinated.

How can I get an appointment?

If you would like a referral to the Therapeutic Endoscopy Program, talk with your primary care provider or current gastrointestinal specialist.