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, the doctor will pass a long, flexible, lighted tube (endoscope) through your mouth, esophagus and stomach into the duodenum (first part of the small intestine). After the doctor sees the common opening to ducts from the liver and pancreas, the doctor will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. The doctor will 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 (6) hours (and preferably overnight) before the procedure to make sure you have an empty stomach which is necessary for the best examination.

You should inform the doctor about medications you take regularly and any allergies you have to medications. Tell the doctor if you have an allergy to iodine-containing drugs, which include contrast material. Although an allergy does not prevent you from having ERCP, it's important to discuss it with the doctor prior to the procedure. Also, be sure to tell the doctor if you have heart or lung conditions, or other major diseases.

WHAT CAN I EXPECT DURING ERCP?

The doctor may apply a local anesthetic to your throat or give you a sedative to make you more comfortable. Some patients also receive antibiotics before the procedure. You will lie on your left side on an X-ray table. The doctor will pass the endoscope through your mouth, esophagus, stomach and into the duodenum. The instrument does not interfere with breathing, but you night feel a bloating sensation because of the air introduced through the instrument.

WHAT ARE POSSIBLE COMPLICATIONS OF ERCP?

ERCP is a well-tolerated procedure when performed by our specially trained and experienced doctors. Although complications requiring hospitalization can occur, they are uncommon. Complications can include pancreatitis (an inflammation or infection 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 the 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. The doctor will discuss your likelihood of complications before you undergo the exam.

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 may 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.