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Deciding on a hospital for an ERCP

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Had my GB out about 6 months ago and according to recent CT-Scan at Pattaya City Hospital (where I live), I have "few CBD stones". Which is bad news, means I likely have retained stones if the CT-scan is correct and I need an ERCP to get them out safely. Apparently, the ERCP is a somewhat challenging operation, unlike the original Cholecystectomy (which went without a hitch).

I have been doing some research on which hospital to choose, based on what I can read on this forum (including the one thread on SIPH), as well as LLMs and talking to anyone I can find. I would like to try and further that knowledge by posting here.

Possible complications: BMI 36 with OSA so prob require General Anesthesia/intubatin instead of the standard sedation.

Priorities: 1. Safety/surgery and anesthesia success. 2. Cost (paying out of pocket. I am retired here). I do not care about luxury, brand names or fancy rooms. Hopefully I will only be there one night, just to make sure my pancreas is ok.

Hospitals I have been looking at, seriously, in order of my current ranking of them, for my specific needs:

  1. Thonburi 1. Not so expensive and high level doctors with high volume for this kind of thing.

  2. SIPH (Siriraj Piyamaharajkarun Hospital). Same high level docs but more expensive with the added advantage of a physically connected to Siriraj Public Hospital, in case of life-threatening complications?

  3. Samitivej Sriracha. Closer. Not sure that matters much unless I need a followup consult or something. But not as good 'life-saving measures' on site as the others? Could require transferring to a tier 1?

  4. Phyathai 2. Maybe shorter wait time for procedure, since it's the only purely private one in the list?

Open to other ideas but this is where I am at, at the moment.

Open to discussion, would like @Sheryl 's opinion, as well, if possible.

ERCP requires specialized equipment and a doctor experienced in its use. Any large private hospital will usually have this but only higher tier government hospitals.

Actually every hospital you list is private though in the case of SIPH, it is a private branch of a government hospital. And for this reason, there is often a wait to get procedures scheduled. With CBD stones, a wait is unadvisable. You want to get this done ASAP, as if complete blockage occurs it becomes a medical emergency.

As long as the hospital has the necessary equipment, choice of hospital is not so important, it is the choice of doctor that matters most. I suggest for this Prof.Somchai Leelakusolvong who is at both Thonburi and SIPH. Costs at Thonburi are usually almost same as SIPH, maybe just a tad more, and scheduling is faster. It is a solid, no-frills hospital popular with the Thai middle class.

https://www.thonburihospital.com/en/doctorprofile/?page=1&department=288

https://www.siphhospital.com/en/medical-services/doctor-biography?id=100

Call ahead to Thonburi to make sure he will be there, schedule says Thursday & Saturday but their website is not always up to date.

  • Author

Thank you @Sheryl . I really appreciate and respect your advice on health matters in Thailand. I apologize if any of my questions are silly. I haven't had a lot of health problems in Thailand, so far. Except for the cholecystectomy that likely led to the retained stones I have now.

16 minutes ago, Sheryl said:

And for this reason, there is often a wait to get procedures scheduled. With CBD stones, a wait is unadvisable. You want to get this done ASAP, as if complete blockage occurs it becomes a medical emergency.

Agreed. I understand ERCP can be dangerous if it turns into Cholangitis so I am not putting it off indefinitely. I have done kidney tests (all normal) and I am asymptomatic so I am trying not to rush too fast. I have an appt. to get an MRCP done here in Pattaya, tomorrow, at the imaging center to confirm my stones since I read that CT-Scans are only ~80% accurate for CBD stones. I need to wait a bit to let the Mounjaro leave my system, anyway, from what I understand.

18 minutes ago, Sheryl said:

As long as the hospital has the necessary equipment, choice of hospital is not so important, it is the choice of doctor that matters most.

From what I understand, the hospital isn't as important for the procedure itself (except there is some new tech called spyglass, maybe?) but if there is an emergency, say from my OSA, then the ability to save my life may depend on having the correct specialists and facilities on hand, rather than having to transfer me?

21 minutes ago, Sheryl said:

I suggest for this Prof.Somchai Leelakusolvong who is at both Thonburi and SIPH. Costs at Thonburi are usually almost same as SIPH, maybe just a tad more, and scheduling is faster. It is a solid, no-frills hospital popular with the Thai middle class.

Oh, really? Ok, I thought Thonburi 1 was cheaper! I have been finding it difficult to estimate costs. I tried to use LLMs for this part. With some discrepancies, they ranked them as SIPH, Phyathai 2, Samitivej Sriracha, Chaophya, Thonburi 1.

Note: From what I could find, there are 3 Thonburis (Thonburi 1 (cheaper), Thonburi 2 (mid tier), Thonburi Bamrungmuang (luxury)? Please correct me if I am mistaken, I am going to assume you and I are talking about Thonburi 1.

I want to spend money on safety but save money on luxury, especially if something goes wrong and I am stuck in a hospital room for a week or more. I don't need frills and if I need to use google translate with the staff, that's fine. But I don't want to skimp on the actual health aspect.

Dr. Leelakusolvong looks like a solid choice! He seems like he might be hard to get an appt with, though, since he's pretty famous. Assoc. Prof. Nonthalee Pausawasdi also looks good (research papers on post-ERPC pancreatitis prevention). Know anything about her? If Dr. Leelakusolvong is unavailable anytime soon, who would you suggest as a backup plan?

Any other hospitals you would recommend for me that are high in safety and relatively low in cost, with 'luxury' being a non-factor?

Any hospital able to do ERCP will have ICU facilities etc. and not need to trabnsfer you if there are complications.

Yes, referring to Thonburi 1 hospital. Owing to its close proximity to Siriraj (almost walking distance) many of the Siriraj senior faculty have hours there. I haven't really found the other Thonburi branches to differ that much in price but they definitely differ in the seniority/experience of their doctors as the others are farther away from main teaching hospitals.

Usually at Thonburi it is first come, first serve and if you show up at least an hour or two ahead of time you'll be seen. Whereas at SIPH it is harder. As long as Prof. Leelakusolvong is there, I think you'll be able to see him at Thonburi and then arrange admission etc all in one visit. Much harder at SIPH.

Prof. Nonthalee is indeed very well qualified but as far as I know, only at SIPH.

Thonburi Hospital is about as inexpensive as you are going to find short of going to a private hospital. As for "luxury", there is definitely none there but this is not as related to cost as one might think it to be. It is a common myth among expats that private hospitals are expensive because of fancy rooms and other frills. These are actually not major cost drivers. Costs at private hospitals have more to do with who is their clientele, and the fancier accommodations are just something added on as part of what the higher paying clientele expect...not the reason for the higher costs.

Another alternative would be Saint Louis Hospital, this doctor https://saintlouis.or.th/doctor/assoc.prof.dr.pradermchai-kongkam/506ab8d3-1698-4c3b-aa2f-13974b161a7d

This doctor is the head of Chulalonhkorn's Center of Excelelnce for Endoscopy Center.

St Louis is nonprofit and also "no frills", nonetheless in my experience it often costs a bit more than Thonburi, probably due to location and drawing in better off foreigners. It may however be more convenient in terms of location for someone coming from Pattaya and that needs to be factored in.

AI tools are not very accurate with regard to health care costs in Thailand. And in any event, cost differences among private hospitals are relatively small, much less than one would perhaps expect. The only big exceptions come into play when some offer special packages but ERCP is not common enough that there are likely to be any.

To really save money you could have this done at Chula. While this is possible, it would entail more trips to Bangkok and longer waits...and coming from Pattaya these extra trips will entail costs that may offset the savings in hospital fees. If you want to try this, though, use the Chula "specialclinic". https://spcweb.kcmh.or.th/users/users/searchDoctor

Open in Chrome for translation, select "Gastrointestinal/Kiver Disease parttime" from the menu and then one of these doctors

Prof. Rungsun Rerknimitr

Assoc. Prof. Wiriyaporn Ridtitid

Asst. Prof. Parit Mekaroonkamol

Spellings may vary a bit in Chrome trabslation.

You have to call to make the appointment, and be ready for a long wait at consultation and need for additional visits just to get things scheduled

  • Author
15 minutes ago, Sheryl said:

Usually at Thonburi it is first come, first serve and if you show up at least an hour or two ahead of time you'll be seen. Whereas at SIPH it is harder. As long as Prof. Leelakusolvong is there, I think you'll be able to see him at Thonburi and then arrange admission etc all in one visit. Much harder at SIPH.

Do you have to do a walk-in during his office hours? Since it's a tad far, I was thinking to call and make an appointment after I get my MRCP, tomorrow. When you say "arrange admission" do you mean right then and there? Or schedule it in the future? When you say it's harder at Siph, do you just mean it's a longer wait or something else?

Just trying to plan the trips. Trying to bring as much info they will need, with me. The MRCP, CT-Scan, liver tests, amylase, lipase, cystatin-c, etc.

Can you give me an idea of the process for both Thonburi 1 and SIPH (or Chula for that matter)?

20 minutes ago, Sheryl said:

Prof. Nonthalee is indeed very well qualified but as far as I know, only at SIPH.

Think she's worth braving SIPH? I guess I am not clear on the downsides of going to SIPH.

33 minutes ago, Sheryl said:

St Louis is nonprofit and also "no frills", nonetheless in my experience it often costs a bit more than Thonburi, probably due to location and drawing in better off foreigners. It may however be more convenient in terms of location for someone coming from Pattaya and that needs to be factored in.

He looks good, too. I may be wrong but I am still thinking this will be one trip, two at most? An extra couple hours to get to the other hospitals is a small price to pay for safety. It sounds like you think they are all equally safe, though. So I guess it's just price, then.

Think I can get a decent estimate from them if I call and ask for a financial coordinator or email them? Maybe I should just email all of them or call all of them and get some estimates if they will oblige.

36 minutes ago, Sheryl said:

AI tools are not very accurate with regard to health care costs in Thailand. And in any event, cost differences among private hospitals are relatively small, much less than one would perhaps expect. The only big exceptions come into play when some offer special packages but ERCP is not common enough that there are likely to be any.

Yes, I notice that about the prices. I was hoping the prices were correct in relation to each other, if not the actual price. But I guess that's wrong, too. That's one reason I wanted to make a post. I can't find a ton about prices online, either. That said, in Pattaya, I would say there's a pretty big diffrence between, say Bangkok Pattaya Hospital and Pattaya Memorial. Even just the same meds I have purchased in the past are 40-50% more at BPH, iirc.

1 hour ago, Sheryl said:

To really save money you could have this done at Chula. While this is possible, it would entail more trips to Bangkok and longer waits...and coming from Pattaya these extra trips will entail costs that may offset the savings in hospital fees.

A trip to BKK is maybe 3k baht. Wasted time, too, ofc. But otoh, this is a fairly expensive procedure form what I understand, even if nothing goes wrong. Like 200,000? Hard to find prices. https://www.health-tourism.com/ercp/thailand/ has Bumrungrad at $6k ish and Chaophya at $2100 but that's probably old. Not sure if I will need general anesthesia, due to OSA and BMI.

So I am thinking that even a 20% difference in price might be pretty substantial if it's 200k. And that's if nothing goes wrong. I am more worried about if something happens and I am there for a week or two, then the costs might get out of control.

As a side note, I had my cholecystectomy not that long ago at Vimut-Theptarin. I should see if I can get the anesthesia and operation records. Maybe that iwll be helpful, as well.

Thanks again for your insights. Is there a way I can pay you back? Do you take donations? =)

1 hour ago, QuantumQuandry said:

Do you have to do a walk-in during his office hours? Since it's a tad far, I was thinking to call and make an appointment after I get my MRCP, tomorrow. When you say "arrange admission" do you mean right then and there? Or schedule it in the future? When you say it's harder at Siph, do you just mean it's a longer wait or something else?

Just trying to plan the trips. Trying to bring as much info they will need, with me. The MRCP, CT-Scan, liver tests, amylase, lipase, cystatin-c, etc.

Can you give me an idea of the process for both Thonburi 1 and SIPH (or Chula for that matter)?

Think she's worth braving SIPH? I guess I am not clear on the downsides of going to SIPH.

He looks good, too. I may be wrong but I am still thinking this will be one trip, two at most? An extra couple hours to get to the other hospitals is a small price to pay for safety. It sounds like you think they are all equally safe, though. So I guess it's just price, then.

Think I can get a decent estimate from them if I call and ask for a financial coordinator or email them? Maybe I should just email all of them or call all of them and get some estimates if they will oblige.

Yes, I notice that about the prices. I was hoping the prices were correct in relation to each other, if not the actual price. But I guess that's wrong, too. That's one reason I wanted to make a post. I can't find a ton about prices online, either. That said, in Pattaya, I would say there's a pretty big diffrence between, say Bangkok Pattaya Hospital and Pattaya Memorial. Even just the same meds I have purchased in the past are 40-50% more at BPH, iirc.

A trip to BKK is maybe 3k baht. Wasted time, too, ofc. But otoh, this is a fairly expensive procedure form what I understand, even if nothing goes wrong. Like 200,000? Hard to find prices. https://www.health-tourism.com/ercp/thailand/ has Bumrungrad at $6k ish and Chaophya at $2100 but that's probably old. Not sure if I will need general anesthesia, due to OSA and BMI.

So I am thinking that even a 20% difference in price might be pretty substantial if it's 200k. And that's if nothing goes wrong. I am more worried about if something happens and I am there for a week or two, then the costs might get out of control.

As a side note, I had my cholecystectomy not that long ago at Vimut-Theptarin. I should see if I can get the anesthesia and operation records. Maybe that iwll be helpful, as well.

Thanks again for your insights. Is there a way I can pay you back? Do you take donations? =)

  1. At any hospital, you have to consult doctors when they have office hours. As mentioned, should call to confirm those hours as sometimes website is out of date or a doctor will not be in for one reason or another. For both Thonburi and St Louis, you can call and ask to make appointment but, even if given one, the time is just an approximate and it still seems to be first come. SIPH on the other hand requires appointment.

  2. SIPH: there is often a sizable delay in getting an appointment (though I have at times succeeded in pleas for one sooner than offered). The biggest delay comes in then scheduling admission or a procedure, that can take weeks or more. About a year ago I accompanied a Cambodian friend with prostate issues there, multiparametric MRI was recommended and would have been a month wait for it, then again as much or more for biopsy if (as proved the case) it was indicated. The doctor himself suggested that Thonburiwould be quicker, and it was immediately arranged there. Which would not have been an option had that doctor not also had privileges at Thonburi.

  1. When you arrange admission, you can do it for whenever is convenient & doctor available, what I meant is you can make that arrangement right on the spot after the consultation and it will usually be possible to schedule quite soon if that is what you want, often even the very next day. In other words, usually no wait list for procedures per se. Yes 1-2 trips at the private hospitals but Chula may be more, or might need a longer stay at the first trip to get everything set up. You would likely have to come back a second time, during government working hours, to schedule the procedure and, as at SIPH, there may be a wait list. You might also have to make separate visits for preliminary blood work and (if they will use general anesthetoc) EKG etc. At a minimum they will likely want a blood count, blood sugar, coagulation profile and EKG unless you have these results available from within say past month). Whereas at a private hospital this will all be done at admission on the spot. Just in general things go more slowly and there is more red tape when using a government hospital, and that does include SIPH even though it is technically private.

  1. However I would expect total costs at Chula to be less than half that of the private hospitals...maybe even a third. SIPH, being technically private wing, will be only about 10% less than the mid-range (price wise) private hospitals mentioned.

  1. You can try to get cost estimates by phone but have a Thai speaker do it and make sure they can clearly name & spell the procedure. Emails may or may not be answered by Thonburi and St Louis, won't be by Chula for sure. SIPH actually does answer emails and even though you might opt to go elsewhere, their price would be useful to know as Thonburi is not likely to be a whole lot more. Note that cost estimates will be for the procedure and normal anesthetic (Usually IV sedation eg propofol), if it isd determined that due to your other conditions general anesthesia is required that would up the cost.

You would be in safe hands with any of the doctors and facilities discussed. What is not safe would to delay if the MRCP confirms stones in the CBD and any are larger than 5 mm.

As for donations, just pay it forward for someone else. :)

Dr Veeravich at Bumrungrad is good.

US trained

Expensive, reckon 9000 B.

  • Author
On 2/24/2026 at 7:25 PM, Sheryl said:

At a minimum they will likely want a blood count, blood sugar, coagulation profile and EKG unless you have these results available from within say past month). Whereas at a private hospital this will all be done at admission on the spot. Just in general things go more slowly and there is more red tape when using a government hospital, and that does include SIPH even though it is technically private.

Ok. I have done a CBC, LFT, Amylase, Lipase and Cystatin-C, Urinalysis and Electrolytes a week ago. In addition to what you mentioned (FBS, coagulation profile and EKG), anything else you think they will surely want? Since that's only a little more, I might try to pre-empt them and just bring the results with me.

On 2/24/2026 at 7:25 PM, Sheryl said:

However I would expect total costs at Chula to be less than half that of the private hospitals...maybe even a third. SIPH, being technically private wing, will be only about 10% less than the mid-range (price wise) private hospitals mentioned.

That's quite significant. And if there is a complication, that could be even more significiant. I hadn't really considered Chula before as it didn't come up in my list of "safest/best hospitals". You think they are just as safe (in "ability to rescue" as well as likelihood of avoiding complications in the first place)?

I am all for being a smart consumer and I am not obstructed so I think I can afford an extra week or so. But I don't want to compromise my safety.

On 2/24/2026 at 7:25 PM, Sheryl said:

What is not safe would to delay if the MRCP confirms stones in the CBD and any are larger than 5 mm.

As for donations, just pay it forward for someone else. :)

I will get the results of the MRCP tomorrow, wish me luck. From what I read, the odds of me having an obstruction in the next year are only like 5%, given that I am asymptomatic and tests show no inflammation/obstruction. Don't get me wrong! I am not putting it off if I have stones. I just mean an extra week or two to arrnage at Chula or SIPH or wherever.

As for paying it forward...coincidentally, I was on the way home from my MRCP and an old employee of mine in the Philippines just pleaded to borrow 40,000 php for a hysterectomy. She was a good girl so I am going to help her out. Maybe an opportunity for a little karma, as well. Not that I am superstitious but she was a good person, anyway.

  • Author
36 minutes ago, Sheryl said:

Chula is once of the 2 top university hospitals in Thailand. Very safe, well equipped.

I was just about to contact Chula and I got my MRCP results back and I think I am good!

"Prominent size of CBD, measuring about 0.8 cm in diameter without filling defect and noted normal distal tapering, possibly post cholecystectomy change."

"Pancreas: Unremarkable"

Renal Findings (The Follow-up Items)

"Mild bilateral perinephric fluid."

"A few bilateral renal cysts, up to 1.5 cm, Bosniak I."

The discussion is no less appreciated, though! There is always the possibility that the MRI is wrong and it's good to have a backup plan. I will do another LFT in a couple weeks and make sure nothing is wonky.

I suppose I still need to look into the "Mild bilateral perinephric fluid" but big sigh of relief about the no stone finding!

22 minutes ago, QuantumQuandry said:

I was just about to contact Chula and I got my MRCP results back and I think I am good!

"Prominent size of CBD, measuring about 0.8 cm in diameter without filling defect and noted normal distal tapering, possibly post cholecystectomy change."

"Pancreas: Unremarkable"

Renal Findings (The Follow-up Items)

"Mild bilateral perinephric fluid."

"A few bilateral renal cysts, up to 1.5 cm, Bosniak I."

The discussion is no less appreciated, though! There is always the possibility that the MRI is wrong and it's good to have a backup plan. I will do another LFT in a couple weeks and make sure nothing is wonky.

I suppose I still need to look into the "Mild bilateral perinephric fluid" but big sigh of relief about the no stone finding!

Mild bilateral perinephric fluid in kidney is a common finding and often benign.

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