ERCP

What is ERCP?

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an endoscopic procedure that examines the bile ducts, pancreas, and gallbladder. ERCP is performed using an endoscope (a long, flexible, lighted tube) and fluoroscopy (a type of real-time X-ray).

Uses

ERCP is used to treat problems of the pancreas or bile ducts that can cause abdominal pain and jaundice. ERCP may be used to:

• Open the entry of the ducts into the bowel or drain blocked ducts
• Stretch out narrow segments of the bile ducts
• Remove or crush gallstones
• Diagnose conditions such as biliary cirrhosis or sclerosing cholangitis
• Biopsy the pancreas, bile ducts, or gallbladder

What to Expect

To begin, patients receive a local anesthetic, either gargled or sprayed on the back of the throat. A needle is then inserted into a vein in the arm if sedatives will be given. Doctors and other medical staff monitor vital signs while patients are sedated.

During ERCP, you may be instructed to lie on your back or side. Your digestive health provider inserts an endoscope down the esophagus, through the stomach, and into the duodenum. Video is transmitted from a small camera attached to the endoscope. A tube (catheter) is then slid through the endoscopy and guided through the papillary opening. Your doctor will inject a dye into the ducts that allow them to be seen with an x-ray, so your provider can identify any narrowed areas or blockages.

How Long Does an ERCP Take?

The procedure takes anywhere from 30 minutes to an hour. After the procedure, patients are taken to a recovery room where they will be monitored for any complications. Most people can go home the same day.

Risks and Complications

As with any medical procedure, there are some risks associated with ERCP. These may include:

• Perforation (tearing) of the bile duct, pancreas, or intestine
• Infection
• Allergic reaction to the dye or sedatives used
• Breathing problems due to sedation

ERCP is generally a safe procedure, but as with any medical procedure, there are some risks involved. Be sure to discuss these risks with your doctor prior to the procedure.

Procedure Prep

ERCP does not require any special preparation, but you will need to fast for at least six hours prior to the procedure. Your doctor will likely tell you to avoid eating or drinking anything after midnight on the night before your procedure. You may be asked to stop taking certain medications prior to the procedure as well. Be sure to follow your doctor's instructions carefully.

View complete ERCP prep instructions.

What to Bring

You will need to bring a driver with you to the procedure as sedation will be used during the procedure. You will also want to wear comfortable clothing as you will be lying down for the procedure.

You should also bring any important medical information with you, such as a list of medications you are taking, your insurance card, and a photo ID.

Sources

• U.S. National Library of Medicine (NIH)