ERCP

What is ERCP?

Endoscopic retrograde cholangiopancreatography, or ERCP, is a specialized technique used to study the ducts of the gallbladder, pancreas, and liver. Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts.

During ERCP, we will pass an endoscope through your mouth, esophagus, and stomach into the duodenum (first part of the small intestine). An endoscope is a thin, flexible tube that lets us see inside your gastrointestinal tract. After we see the common opening to ducts from the liver and pancreas, we will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. We will then inject a contrast material (dye) into the pancreatic or biliary ducts and will take X-rays.

What Preparation is Required?

You should fast for at least six hours (and preferably overnight) before the procedure to make sure you have an empty stomach, which is necessary for the best examination.

You should talk to us about medications you take regularly and any allergies you have to medications. Tell us if you have an allergy to iodine-containing drugs, which include contrast material. Although an allergy doesn’t prevent you from having ERCP, it’s important to discuss it with us prior to the procedure.

Also, be sure to tell us if you have heart or lung conditions, or other major medical conditions.

What Can I Expect During ERCP?

First, you will meet an anesthesiologist who will administer anesthesia to you during the procedure. With the anesthesia, you will be completely comfortable and should not have any recollection of the procedure. Some patients also receive antibiotics before the procedure. You will lie on your stomach on an X-ray table. We will pass the endoscope through your mouth, esophagus, stomach, and into the duodenum. The instrument does not interfere with breathing, but you might feel a bloating sensation because of the air introduced through the instrument.

What Are Possible Complications of ERCP?

Although complications requiring hospitalization can occur, they are uncommon. Complications can include pancreatitis (an inflammation of the pancreas), infections, bowel perforation, and bleeding. Some patients can have an adverse reaction to the sedative used. Complications are often managed without surgery.

Risks vary, depending on why the test is performed, what is found during the procedure, what therapeutic intervention is undertaken, and whether a patient has major medical problems. Patients undergoing therapeutic ERCP, such as for stone removal, face a higher risk of complications than patients undergoing diagnostic ERCP. We will discuss your likelihood of complications before you undergo the test.

What Can I Expect After ERCP?

If you have ERCP as an outpatient, you will be observed for complications until most of the effects of the medications have worn off. You might experience bloating or pass gas because of the air introduced during the examination. You can resume your usual diet unless you are instructed otherwise.