ERCP (Diagnostic) cost in Singapore

Treatment and Cost

3

Total Days
In Country

2 No. Travelers

0 Day in Hospital

3 Days Outside Hospital

Treatment cost starts from

USD 11000

Hospitals

About the ERCP (Diagnostic)

ERCP procedure or Endoscopic Retrograde Cholangio-Pancreatography is an assessment as well as a procedure meant for rectifying problems in bile and pancreatic ducts. This is considered to be a very critical and life saving procedure involving an endoscope. Examination of critical areas needs to be done and rectification has to be done immediately with planned procedural steps.

Who needs an ERCP?

An ERCP procedure is recommended in order to diagnose the status of bile ducts and the pancreas and if there are problems discovered during diagnosis then they are treated as well. The procedure is appropriate in order to do evaluation of symptoms that are suggestive of certain diseases prevalent in these organs. It is also used as a method of reconfirmation of abnormal results generated from ultrasound, CT scan or imaging tests and blood tests. If CT scan reveals abnormal mass or stones in these organs then ERCP is recommended.

The procedure can even be performed before and after a gall bladder surgery to help in the conducted operation’s performance in overall. If there are stones or tumours of both cancerous and non cancerous nature then they can be removed with the help of ERCP procedure from bile ducts and pancreas. If there have been any complications noted during gall bladder surgery then those can also be diagnosed with the help of this. Patients having any pancreatic disease or suspected disorder for them the ERCP method can suggest the requirement of surgery and the type of surgery that may be best for the treatment. In some cases pancreatic stones can be addressed and removed with the help of ERCP procedure.

Causes of ERCP

Causes of the problems are mainly because of narrowing or blockage of the bile ducts and pancreatic duct. Gall stones are formed and they get stuck to the common bile duct thus requiring surgical interventions. Gall stones are usually formed of cholesterol in maximum cases while for 20% cases it is a result of calcium and pigments like bilirubin giving rise to stones. Other causes can be imbalance of diet and irregular lifestyle giving rise to infection. Alcohol drinking and fatty food consumption results in acute and chronic pancreatitis.

Symptoms of ERCP

The way to know that you may be a patient requiring ERCP is:

  • Abdominal cramps
  • Fever and Nausea
  • Vomiting tendency with occasional bleeding
  • Irritation felt in the stomach
  • General fatigue experienced

 

What is ERCP?

The procedure of ERCP enables the doctor or the surgeon to precisely examine the bile ducts and the pancreatic duct. In this procedure the endoscope which is a lighted tube and can be bent as well has a thickness of the index finger almost and it is inserted via the mouth of the patient and then it is made to access the stomach and the small intestine’s first part that is the duodenum. A small plastic tube named cannula is passed via the endoscope into the opening which is very small in size in the duodenum. The opening is called the ampulla. A contrasting substance or a dye is then injected and then X rays are carried out to start the study and find the status of the liver, pancreas and the ducts.

How is ERCP (Diagnostic) performed?

ERCP surgery

The surgery technique makes use of a combination of luminal endoscopy compiled with fluoroscopic technique of imaging for the purpose of diagnosing and performs treatment of conditions that are associated with pancreatobiliary system. A side viewing instrument named the duodenoscope is utilized in the endoscopic portion that is made to travel through the esophagus and reach the stomach to access the duodenum’s second portion which is the part of small intestine.

In ERCP Sphincterotomy both fluoroscope and endoscope are employed and deep cannulation is done of the bile duct which is then followed by the sphincter of Oddi’s severance with electrocautery (heating).

Coming back to conventional ERCP, next the duodenal pailla is identified with the scope in the position discussed above and further inspection is carried out to find any abnormalities. The duodenal papilla is like a structural protrusion of the ampulla of Vater or the hepatopancreatic ampulla into the duodenal lumen. The ventral pancreatic duct and the common bile duct have a convergence point and that is this ampulla. So this ampulla behaves like a channel for draining pancreatic secretions and bile into the duodenum.

If contrast is injected into the pancreatic duct or if the pancreatic duct gets cannulated for quite a number of times then a temporary pancreatic duct stent placement or rectally administered NSAIDS (diclofenac or indomethacin) has to be considered. This has to be considered aiming to reduce the post-ERCP pancreatitis (PEP) risks. For PEP prophylaxis these two prevention modalities have shown some promise.  Somatostatin, gabexate, heparin, nitroglycerin, allopurinol, steroids, octreotide and many more pharmacological agents have been studied but the results found were pretty disheartening.

In the second portion or segment of the duodenum the minor duodenal papilla is also located and it behaves like an access point for the dorsal pancreatic duct. Dorsal pancreatic duct’s evaluation with ERCP is seldom performed and the ERCP indications are further discussed below:

With the side viewing endoscope the papilla is closely examined and then selective cannulation of ventral pancreatic duct or common bile duct is performed. Once the cannulation of the selected duct is performed then either pancreatogram of the pancreatic duct or cholngiogram of common bile duct is obtained fluoroscopically with the injection of a material that is radiopaque contrasting in nature is done into the duct. These days ERCP is considered by surgeons like a therapeutic surgery where abnormalities that are observed via a fluoroscope can be particularly addressed by the methods of specialized accessories that can be passed via the endoscope’s working channel.

This procedure is a very advanced process and as a result of this serious complications tend to occur at a higher frequency than many other endoscopic processes. As per that special training and specialized devices and equipments are employed and for appropriate indications only this procedure is employed.

Indications that have been recorded for biliary diseases are given below:

Assessment of biliary obstruction and its treatment secondary to choledocholithiasis- if ascending cholangitis, worsening pancreatitis or worsening jaundice which are persistent are present then Precholecystectomy ERCP may be indicated.

  • With intraoperative cholnagiography or common bile duct exploration without the extraction of stone, treatment of choledocholithiasis is identified during cholcystectomy.
  • Bile duct stricture assessment and subsequent treatment- bening and malignat strictures and and congenital abnormalities of the bile duct.
  • Postoperative complications
  • Postoperative biliary leaks’ treatment and assessment
  • Sphincter of Oddi dysfunction of selected patients, their assessment with treatment with little benefit in modified Milwaukee classification type III patients
  • For recurrent and acute pancreatitis for which the underlying cause is unknown in patients; their treatment followed after assessment
  • Symptomatic strictures associated with chronic pancreatitis; assessment and treatment
  • Symptomatic pancreatic duct stones; their treatment after assessment
  • Symptomatic duct stones’ assessment and treatment

Pancreatic malignancies can be diagnosed and the indications are:

  • Biopsy and brushing of the bile duct
  • Pancreatoscopy
  • Intraductal ultrasonography

There are also indications for ampullary diseases like

  • Assessment of ampullary malignancy
  • Ampullary adenomas’ assessment and treatment

If a patient has the possibilities of developing post ERCP pancreatitis, then the process of diagnosis grows apparent within some hours after the procedure. The patient shall experience severe pain in abdomen back pain and nauseated feelings may be accompanied with vomiting sensation) and some amount of fever is also common. But then the observation period does not stretch beyond an hour after the ERCP procedure and is not enough time for checking for post ERCP Pancreatitis. For evolving post ERCP pancreatitis a two hour serum or urinary amylase level (>1000IU/L) is highly predictive if the patient can be kept under observation for a longer duration of time.

Another kind of procedure closely related to ERCP is the employment of miniature endoscopes that can be inserted via the operating channel of the duodenoscope. These can be directly inserted into the pancreatic or the bile duct. The interior side of the duct can be visualized and accordingly biopsies can be taken. There remain other possibilities for therapeutic interventions.

If in the common bile duct the bile duct stones are seen then the opening of the papilla will be made wider with the help of electrocautery or heating and then the stones are removed. For removal of stones sometimes a basket may be employed. If the narrowing of the bile duct is seen in the X-ray images then a small wire mesh or plastic tube which is a stent can be inserted to facilitate the bypassing of the blockage and allow the bile to move to the duodenum. Very mild pain after ERCP stent placement is felt.

ERCP Complications

ERCP complication chances are vastly reduced when performed by expert surgeons but still there persists some amount of complications like:

  • Pancreatitis or inflammation of the pancreas is the commonly occurring complication found in 3 to 5% of the patients undergoing the surgery. Usually it is mild causing nausea and pain in the abdomen region which can be treated during the stay in hospital. It is very rare that pancreatitis grows severe during ERCP.
  • A cut into the ampulla becomes necessary by the endoscopist and as soon as that happen some amount of bleeding can occur at the site of the cut ampulla. However it is minimal and stops in sometime all by itself or it can be controlled during the surgery.
  • A tear or hole in the intestine can happen accidentally due to the insertion of the scope or any other instrument. This happens rarely but when it occurs it is a serious condition requiring immediate surgical intervention.
  • Infection or cholangitis is also very rare in the bile ducts but if it occurs among patients with preexisting conditions then treatment has to be started where antibiotics need to be administered and drainage of excess fluids need to be carried out.


If by accident food or fluid is inhaled in the lungs then that can be a complication but it rarely occurs in patients who do not drink and eat several hours prior before the ERCP test.

Recovery from ERCP (Diagnostic)

Aftercare and recovery

 As the sedative medications start wearing off the patient will be observed for further complications. The medicines administered causes drowsiness and there are difficulties observed in concentration so a patient will be advised to stay away from work.

The discomfort as most patients have expressed is a feeling of bloating which is a result of the introduction of air in the system during the time of examination but this problems can be quickly fixed.  Some patients experience a throat sore which is very mild usually.

Most patient are in a condition to drink clear liquid after the test and in some scenario blood tests have to be conducted right after the ERCP procedure. If biopsy samples have been taken then they are required to be sent to the lab for further analysis right after the procedure.

Some amount of fatigue is very common during the recovery period and for abnormal temperatures observed one should immediately inform the clinical team to check for the conditions.

Patient Stories

Frequently Asked Questions

How much does ERCP (Diagnostic) cost in Singapore?

The cost of ERCP (Diagnostic) in Singapore starts from $14000. JCI are just some of the accreditations which top hospitals in Singapore hold where a ERCP (Diagnostic) is conducted.

What are the factors affecting the cost of ERCP (Diagnostic) in Singapore?

ERCP (Diagnostic) package cost in Singapore has different inclusions and exclusions. The cost quoted by some of the best hospitals for ERCP (Diagnostic) in Singapore generally covers the pre-surgery investigations of the patient. The treatment cost usually includes the expenses related to hospitalization, surgery, nursing, medicines, and anesthesia. There are many things that may increase the cost of ERCP (Diagnostic) in Singapore, including prolonged hospital stay and complications after the procedure.

Which are some of the best hospitals in Singapore for ERCP (Diagnostic)t?

There are many hospitals across the country that offer ERCP (Diagnostic) to international patients. Some of the best hospitals for ERCP (Diagnostic) in Singapore include the following:

  1. Farrer Park Hospital
How many days does it take to recover post ERCP (Diagnostic) in Singapore?

Upon discharge from the hospital after ERCP (Diagnostic) in Singapore, the patients are advised to stay for about 3 days for recovery. This time frame is important to ensure that the surgery was successful and the patient is fit to fly back.

Which are some of the other popular destinations for ERCP (Diagnostic)?

Singapore is one of the most popular countries for ERCP (Diagnostic) in the world. The country offers the best cost of ERCP (Diagnostic), best doctors, and advanced hospital infrastructure. However, there are other countries as mentioned below that are popular for ERCP (Diagnostic) as well:

CountryCost
IndiaUSD 800
SingaporeUSD 14000
TurkeyUSD 4500
How much are the other expenses in Singapore apart from the cost of ERCP (Diagnostic)?

There are certain additional cost that the patient has to pay apart from the ERCP (Diagnostic) cost. These charges starts from USD 50 per person.

Which are the best cities in Singapore for ERCP (Diagnostic) Procedure?

Some of the best cities in Singapore which offer ERCP (Diagnostic) are:

  1. Singapore
How many days does one have to spend in the hospital for ERCP (Diagnostic) in Singapore?

The patient has to spend about 1 day in the hospital after ERCP (Diagnostic) for proper recovery and to get clearance for discharge. This phase is important to ensure that the patient is recovering well and is clinically stable. During this time, several tests are performed before the patient is deemed suitable for discharge.

What is the average rating of Hospitals in Singapore offering ERCP (Diagnostic)?

The average rating for ERCP (Diagnostic) hospitals in Singapore is 2.7. This rating is calculated on the basis of different parameters such as attitude of the nurses, cleanliness, quality of food and the pricing policy.

How many hospitals offer ERCP (Diagnostic) in Singapore?

There are more than 1 hospitals that offer ERCP (Diagnostic) in Singapore. The above mentioned clinics have the required infrastructure and a dedicated unit where patients can be treated. These hospitals comply with all the rules and regulations as dictated by the regulatory bodies and medical association in Singapore

Who are the best doctors for ERCP (Diagnostic) in Singapore?

Some of the most sought after medical specialists for ERCP (Diagnostic) in Singapore are:

  1. Dr. Lee Keat Hong
  2. Dr. Chong Siong Eng Roland
  3. Dr. Chuah Sai Wei
  4. Dr. Guan Richard

FAQ's Related to Singapore

What healthcare accreditation standards are followed in Singapore?

The hospitals in Singapore are all apprised and then given accredition by Joint Commission International, the premier accredition agency in the world. Healthcare quality and patient safety parameters are assessed by the Joint Commission International or JCI. Hospitals in Singapore are apprised on Organisation management and accredited by the Joint Commission International gives it great value and good standing. It is only after stringent assessment measures that hospitals in Singapore are given the certification by the Joint Commission International.

Which are the popular multispecialty hospital groups in Singapore?

The popular multi specialty hospital groups in Singapore are as follows

  1. Mount Elizabeth Hospital
  2. Raffles Hospital
  3. National University Hospital
  4. Gleneagles Hospital
  5. Singapore General Hospital
  6. Changi General Hospital
  7. Johns Hopkins Singapore International Medical Centre
  8. Tan Tock Seng Hospital
  9. Parkway Hospitals Singapore

The popular multispecialty hospitals in Singapore give the best medical treatment and it is no wonder that these hospitals are truly international in the form of the diverse patient population that frequents them. The high benchmark of the popular multispecialty hospitals in Singapore is due the wide coverage in terms of the specialties covered by these hospitals and the quality of specialists operating in the hospitals. In the popular multispecialty hospitals in Singapore you get the best of medical treatment in short waiting times.

Why should I opt for healthcare in Singapore?

Do opt to get healthcare in Singapore because of the highly developed infrastructure which is vouched for by one and all. The healthcare community and healthcare providers in Singapore are best known for providing the best of clinical care and aiming for the highest clinical outcomes. The commitment to providing the best in terms of service quality is one of the most important reasons for anyone to choose Singapore as a healthcare destination. The ease of travel and access to quality healthcare are the reasons that make Singapore an attractive medical tourism destination.

What is the quality of doctors in Singapore?

It is important to know that with immense practical knowledge in their specialisation and being thorough professionals, doctors in Singapore are among the chosen few. The absolute precision and efficiency sought makes the doctors in Singapore some of the best in the world. The quality of doctors in Singapore will be high considering that with an influx of international medical tourist, doctors in Singapore have a vast international exposure. The presence of sharp skills and being educated from the best of the educational institutions means that the doctors in Singapore are most sought after by the patients.

When traveling to Singapore for medical treatment, what essential documents do I need to carry along?

We bring to you the list of documents needed for your medical travel to Singapore:

  1. Medical Records and Reports describing your medical condition
  2. Communication from the hospital and/or the doctor that has referred you
  3. Passport
  4. Treatment Plan and Frequency of treatment
  5. Fit to travel confirmation
  6. To and Fro travel tickets
  7. Visa relevant to your visit as a medical traveller to Singapore
  8. Proof of financial means for travel and treatment
  9. Credit Card/Debit Card/Valid internet banking account in Singapore

Please create the document checklist before starting your journey to Singapore as a medical traveller. The documents that you need to carry for your medical treatment to Singapore will be consisting of your financial standing, your travel related documents and the ones that are related to your medical condition. The travel documents that you are carrying with you should cover your requirements as a medical tourist which will make your treatment, stay and travel back as streamlined as possible.

What are the popular procedures available in Singapore?

There are many important popular procedures that are performed in Singapore such as:

  1. Dentistry
  2. Orthopedics
  3. Cardiology
  4. Cosmetic/Plastic Surgery
  5. Ophthalmology

Armed with the best of education and training, healthcare providers in Singapore are performing complex and advanced cardiology procedures everyday. The precision and efficiency shown by doctors in the hospitals in Singapore in performing Orthopaedic surgery procedures has meant that they are one of the most popular procedures in Singapore. Singapore is a hub for cosmetic surgery procedures such as:

  1. Liposuction
  2. Rhinoplasty
  3. Face Lift
  4. Breast Augmentation
  5. Blepharoplasty
What are the other facilities provided by hospitals in Singapore?

The major hospitals in Singapore ensure that the stay is comfortable not just for the patient but even the people accompanying them by providing a number of additional facilities. Hospitals in Singapore are constantly putting efforts in making your travel and transfer seamless by providing you facilities such as:

  1. Accommodation
  2. Flight Booking
  3. Airport Transfers
  4. Interpreter

It is pertinent to note that hospitals in Singapore are always seeking to make your medical travel to Singapore easy by enabling private payment gateways and the wide availability of private insurance. Whether it be providing health screening, dietitians and pharmacies presence in the hospitals in Singapore, everything is done in line with the patient centric care practiced by the hospitals.

What is the procedure for obtaining medical visa for Singapore?

When you are applying for a medical visa for Singapore visit do check the visa requirements for your country as Singapore has relaxed visa norms vis a vis many countries. We have listed here the required documents for medical visa for Singapore:

  1. Passport with the required time validity
  2. Completed application form
  3. LOI or Letter of Introduction from a local contact in Singapore
  4. A recent passport size photograph
  5. Bio data page photocopy of the passport of the applicant
  6. Covering letter and forwarding letter

It is advised that you check the required visa fee from your country for medical visa for Singapore. It takes atleast five working days to get your medical visa processed (excluding delays due to rush or submission of an incomplete application). Your original bank statements will be checked by the concerned officials in order to assess your financials so that your Singapore medical visa can be granted.