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Endoscopic Retrograde Cholangiopancreatogram – ERCP

An ERCP is a procedure that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ducts.

Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x-rays.

Endoscopic Retrograde Cholangiopancreatogram - ERCP

If you have any questions prior to the procedure, please feel free to discuss them with the ERCP nurse or your physician before the examination begins.

What to Expect

The endoscopic retrograde cholangiopancreatography is an outpatient procedure that should take an hour or two. You will be allowed to go home later the same day. IV sedatives are usually administered to help you remain calm during the procedure. Even though you will remain awake during the procedure, you probably will not remember it. The doctor will numb your throat with a special anesthetic spray and then insert an endoscope into your mouth and guide it through the esophagus and stomach until it reaches the duodenum or upper part of the small intestine. Some air will be pushed through the endoscope to make it easier to see the organs in the region.

A catheter will be slid into the endoscope until it reaches the pancreatic and bile ducts. Dye will be sent through the ducts and a fluoroscopy or a video x-ray will be taken to check for blockages or problems. If the doctor finds any problems, he can send tiny instruments through the endoscope. With these, he can break up or remove stones, place stents to open ducts, or remove tumors or take a tissue sample for a biopsy.

Applicable Conditions

Pancreatic Cysts
Biliary Obstruction

Endoscopic retrograde cholangiopancreatography (ERCP) is an outpatient procedure that is performed in a hospital. If you will be under general anesthesia, the doctor may want to perform a complete physical. The doctor will provide you with a list of things you will need to do and to avoid prior to the procedure. You will be given specific instructions for preparing. Usually, there’s no eating or drinking after midnight on the night before your procedure. Your medications may need to be altered or stopped beforehand. If you have medications to take the day of the procedure, you can usually take them with a sip of water. Please advise the doctor if you have an allergy to iodine or shellfish.

As with any medical or surgical procedure, there are always some possible complications and risks. Some people may experience an allergic reaction to the dye used in the procedure. Should this occur, the doctor will immediately administer medication to stop the reaction. Although other complications are extremely rare, these potential complications could occur.

  • Bleed
  • Bile duct or gallbladder infection
  • Perforation in the stomach, small intestine, or ducts
  • Pancreatitis (inflamed pancreas)
  • Internal bleeding

The endoscopic tubing used during the procedure can cause mild irritation to the throat. The doctor may recommend eating soft foods for a couple of days after the procedure. You may also experience some bloating or nausea. You may be placed on antibiotics and given medication during your procedure to prevent pancreatitis. The doctor will tell you when you can return to work and normal activities. For most people, that is the very next day.

The doctor should be able to tell you the results shortly after the procedure. Your physician will inform you if (s)he had to place stents or remove any stones. If (s)he removed a tumor, you’ll be instructed on the next steps. If (s)he retrieved a tissue sample for a biopsy the results can take a few days. If you need further treatment, your doctor will discuss a treatment plan with you.

You will remain in the treatment area for an hour or two after the sedatives wear off. You will need someone to take you home since sedatives can affect your reflexes and your ability to make decisions. You will be instructed to refrain from driving for the rest of the day.

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