Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP is a procedure that helps your doctor diagnose problems in the liver, gallbladder, pancreas and bile ducts, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), jaundice (yellow coloring of the skin), continuous undiagnosed abdominal pain, and cancer. ERCP combines the use of X-rays and an endoscope, which is a long, thin tube equipped with a light and a video camera that produces images that can be shown on a TV screen.
Preparation
Your stomach and duodenum must be empty for the procedure to be accurate and safe, so you will not be able to eat or drink anything after midnight the night before or for 6-8 hours before the procedure. Your doctor will ask you if you are allergic to contrast dye or medium, which is used during the exam. Female patients should tell their doctor if they believe they may be pregnant before the procedure is scheduled. Heart and blood pressure medication can be taken with a small amount of water in the early morning. If you are on blood thinners, please check with your doctor.
If you are having this procedure as an outpatient, you must arrange for someone to take you home at discharge. You will not be allowed to drive because a sedative is given during the procedure.
Procedure
You will start on your left side and then will be positioned on your stomach on an examining room in our GI X-ray procedure room. You will be given a sedative through an IV to help to relax or sleep. The physician will then guide the scope through your digestive tract to the spot where the bile ducts open into the duodenum. Through the scope, the physician will inject a dye into the ducts to make them show up clearly on X-rays. If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to cut, remove or relieve the obstruction and open the narrowing. Also tissue samples (biopsies) can be taken for further testing.
The ERCP can take from 30 minutes to two hours, depending on what is found on the test. After the test, you will go to the GI recovery area for at least 1 hour while the sedative wears off. You may feel bloated, gassy, nauseated from the medication or the procedure. Depending upon the kind of treatment during the ERCP, you may need to stay overnight at the hospital for observation.
Even though the physician will explain the findings after your procedure, you can call the next day to make sure you understand the results.
Potential Complications
ERCP is considered safe and a low risk for complications. The most common complications include:
- Pancreatitis, or inflammation/irritation of the pancreas
- Infection
- Rupture and bleeding of the duodenum (very rare)
- Drug reactions
- Depressed breathing
- Irregular heartbeat