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, your doctor 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 your doctor see inside your bowels. After your doctor sees the common opening to ducts from the liver and pancreas, your doctor will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. Your doctor will inject a contrast material (dye) into the pancreatic or biliary ducts and will take X-rays. Subsequently, other interventions can follow such as cutting the opening of the bile/pancreatic ducts(called a sphincterotomy), sampling narrowed ducts, dilation of narrowed segments of bile/pancreatic ducts, removal of stones from the bile/pancreatic ducts and finally placement of plastic/metallic stents into the ducts to improve the drainage.
When is ERCP indicated?
ERCP is usually needed to remove stones from the bile/pancreatic ducts and treatment of jaundice secondary to impaired drainage of bile from the liver usually due to tumors of the bile duct/gallbladder or the pancreas
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.
What can I expect during ERCP?
Your doctor might apply a local anesthetic to your throat and give you a sedative to make you comfortable. Some patients also receive antibiotics before the procedure. You will lie on your left side on an X-ray table. Your doctor 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 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.
Someone must accompany you home from the procedure because of the sedatives used during the examination. Even if you feel alert after the procedure, the sedatives can affect your judgment and reflexes for the rest of the day.
