ERCP endoscopic retrograde cholangiopancreatography

What is ERCP?

ERCP (Endoscopic Retrograde Cholangiopancreatography) is a specialized technique used to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines the use of X-rays and an endoscope, which is a long, flexible, lighted tube.

During ERCP, your doctor passes an endoscope through your mouth, esophagus, and stomach into the duodenum (the first part of the small intestine). The endoscope allows your doctor to see the opening where the bile and pancreatic ducts empty into the duodenum. A small tube is then passed through the endoscope and into these ducts, and contrast dye is injected to make them visible on X-rays.

Why is ERCP Performed?

ERCP may be performed to:

  • Remove gallstones that are stuck in the common bile duct
  • Open narrowed or blocked bile or pancreatic ducts
  • Diagnose problems in the bile ducts or pancreas, such as tumors, strictures, or inflammation
  • Place stents to keep ducts open
  • Take tissue samples (biopsies) for analysis
  • Treat complications after gallbladder surgery

Preparation

Before ERCP, you'll need to fast for several hours (typically 6-8 hours) to ensure your stomach and duodenum are empty. Your doctor will provide specific instructions.

Inform your doctor about all medications you're taking, especially blood thinners, as you may need to adjust or temporarily stop them. Also inform your doctor about any allergies, especially to contrast dye or medications.

During the Procedure

ERCP is performed under sedation, so you'll be comfortable and relaxed during the procedure. The procedure typically takes 30-90 minutes, depending on what needs to be done.

Your doctor will guide the endoscope through your digestive tract and use X-ray imaging to visualize the bile and pancreatic ducts. If treatment is needed, specialized instruments can be passed through the endoscope to perform procedures such as removing stones or placing stents.

Risks and Complications

While ERCP is generally safe, potential risks include:

  • Pancreatitis (inflammation of the pancreas) - the most common complication
  • Infection
  • Bleeding
  • Perforation (tear) of the digestive tract
  • Reactions to sedation

Your doctor will discuss these risks with you before the procedure and take steps to minimize them.

After the Procedure

After ERCP, you'll be monitored until the sedation wears off. You may experience some bloating or gas, which is normal.

You'll need someone to drive you home. Your doctor will provide specific instructions about when you can resume eating and taking medications. Contact your doctor immediately if you experience severe abdominal pain, fever, difficulty swallowing, or vomiting after the procedure.