Division of Gastroenterology & Hepatology
ERCP (Endoscopic Retrograde Cholangiopancreatography)
What is ERCP?
ERCP stands for endoscopic retrograde cholangiopancreatography. This procedure is used to view and treat disorders of the bile duct
s and the pancreatic duct. Most often, ERCP is used to treat blockages in these ducts, either from a stone or a narrowing. The procedure can sometimes find the source of abdominal pain and help plan surgery. It may also be used to locate problems in the pancreas. ERCP is done by a gastroenterologist, a doctor with special training in treating the digestive system.
Preparing for ERCP
Talk to your doctor about any health problems you have or medications you take. Discuss any allergies, especially to contrast material (the special dye used for some x-rays)
Ask your doctor about the risks of ERCP. These include pancreatitis, irritation or infection, bleeding, bowel perforation, and reactions to medications used during ERCP.
You may be asked to take antibiotics ahead of time.
Try to avoid blood-thinning medications such as aspirin for 1 week before ERCP.
Be sure your stomach is empty. Do not eat or drink for 8-12 hours before ERCP.
Have someone ready to drive you home and bring clothing and toiletries in case you stay.
X-rays will be taken during the exam, so inform the doctor if you are pregnant.
ERCP is performed in our endoscopy suite. The doctor is assisted by nurses and technicians during the procedure, which usually takes 30-90 minutes. An IV is placed in your arm to give you. Your throat will be numbed with a spray to reduce gagging sensation. You will be asked to lie on your belly facing right. Adjustments can be made if this is not possible for you.
Placing the Endoscope
After you have been medicated to make you sleepy, a narrow tube (endoscope) is placed into your throat. The scope lets the doctor see the way through the esophagus, stomach and the duodenum to the opening of the bile duct. During this part you may have a gagging feeling. You may also feel temporary pressure on your stomach. Once the bile duct opening is reached, you should remain comfortable for the rest of the procedure.
During the procedure, x-rays are taken. Contrast dye is injected to make the ducts show up on the x-ray.
The Bile Ducts and Pancreatic Duct
The bile duct is a small tube that takes liquid bile from the liver/gallbladder to the duodenum, the beginning of the small intestine. Similarly, the pancreatic duct takes pancreatic digestive enzymes to the small intestine through the same opening as the bile duct, called the ampulla of Vater. Blockage of these ducts can occur by gallstones, tumors, strictures, and sphincter dysfunction. This can result in pain, infection and/or jaundice, which is yellowing of the skin. During ERCP, gallstones can be removed from the bile duct and a stent can be placed across any narrowed segments. Also, during ERCP, strictures can be stretched open and specimens can be collected for examination. Where appropriate, sphincter pressure can be measured and sphincter dysfunction treated.
After you wake up from the sedatives, your doctor will discuss the test results with you. A return visit may be scheduled. Most patients go home the same day but some need to spend the night in the hospital.