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FES Written Exam 2026/2027 with Questions and Correct Answers – Instant Download Complete Endoscopy & ERCP Study Guide

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This FES Written Exam 2026/2027 study guide includes detailed practice questions with correct answers covering upper endoscopy, ERCP procedures, patient positioning, sphincterotomy techniques, and prevention of post-ERCP pancreatitis. The material reviews key procedural maneuvers such as evaluation of the GE junction using the J maneuver, selective bile duct cannulation, and pancreatic duct protection strategies. It reinforces essential endoscopic principles including positioning for upper endoscopy and ERCP, biliary sphincterotomy technique, guidewire use, and complication prevention. This complete study guide is designed to support candidates preparing for the Fundamentals of Endoscopic Surgery written examination.

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FES WRITTEN EXAM 2026 WITH
QUESTIONS AND CORRECT ANSWERS

Time frames for upper endoscopy - Familiar polyposis - correct answer-1-2
years




Patient positioning for ERCP - correct answer-prone position with the head
turn toward the right shoulder




patient positioning for upper endoscopy - correct answer-left side down,
head slightly up.




Maneuver to look at the GE junction - correct answer-J maneuver (tip up),
rotate the shaft of the scope CCW and withdraw, pulling the scope into the
proximal body and cardia, rotate the scope 360 around the GE jx,




techniques to decrease post ERCP pancreatitis - correct answer-selective
bile duct cannulation w/ guidewire, stenting pancreatic dut w/ stent or
guidewire for difficult CBD cannulation, limiting contrast injection into the
pancreatic duct

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Technique for billiary sphincterotomy - correct answer-apply pressure w/
cutting wire toward 11 o'clock direction, continue the sphincterotomy until
the intramural portion is cut. Use blended current with cutting and coag at
15-20J. Alt: can use balloon dilation but a/w higher rate of post-ECRP
pancreatitis




Direction of pancreatic cannulation during ERCP - correct answer-1 to 3
o'clock position




When to stop warfarin before ERCP - correct answer-stop 5 days before
and switch to heparin or lovenox if peri-procedural anticoagulation is
required. This can be stopped a day prior to the procedure




rate of post ERCP pancreatitis - correct answer-3-5%




Timing of colonoscopy for first degree relative w/ CRC or adenomas prior to
age 60 - correct answer-colonoscopy at age 40 or 10 years before the
youngest affected relative, whichever is earlier. Then repeat every 5 yrs




Indications for ECRP - correct answer-Tissue sampling - bile duct,
pancreatic duct, ampulla bx
chronic pancreatitis/divisum
pancreatic malignancy
billiary malignancy

, 3 |Page

Benign strictures
Ductal disruption/injury
Jaundice
cholangitis
gallstone pancreatitis
dilated CBD




maneuvers to enter IC valve - correct answer-rotate the scope until the
valve is at the bottom of the visual field, look down into the valve, gently
insufflate air to open up the valve, OR retroflex the tip in the cecum and
shorten the scope (hook the IV valve)




cancer detection rate of brush biopsy - correct answer-20-60%




band ligation vs sclerotherapy for esophageal varices - correct answer-
equal efficacy but baldn ligation has lower complication rate.




cancer detection rate of needle aspiration - correct answer-6-30%




how long after sphincterotomy can the bleeding complication manifest? -
correct answer-immediate up to 14 days

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