An Endoscopic Retrograde Cholangiopancreatography (ERCP) is used to identify issues of the bile ducts, liver, gallbladder, or pancreas.
During an ERCP, your doctor will pass a thin, flexible tube called an endoscope through your mouth, esophagus and stomach into the duodenum (the first part of your small intestine) while you lie on your side on an X-ray table. After your doctor sees the common opening to the ducts from the liver and pancreas, he or she will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. Your doctor will then inject a dye into the pancreatic or biliary ducts and take X-rays.
The instrument does not interfere with breathing, but you might feel a bloating sensation because of the air introduced through the instrument. You can resume your usual diet unless you are instructed otherwise.
Your doctor might 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. If you have ERCP as an outpatient, you will be observed for complications until most of the effects of the medications have worn off. 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.
Feel free to ask your doctor about anything you don't understand.
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. Your doctor will give you precise instructions on how to prepare.
You should talk to your doctor about medications you take regularly and any allergies you have to medications, or intravenous contrast material. Although an allergy doesn’t prevent you from having an ERCP, it’s important to discuss it with your doctor prior to the procedure. Also, be sure to tell your doctor if you have heart or lung conditions, or any other major diseases.
ERCP is a well-tolerated procedure when performed by doctors who are specially trained and experienced in the technique. 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. Sometimes the procedure cannot be completed for technical reasons. Risks vary, depending on why the test is performed, what is found during the procedure, what therapeutic intervention is undertaken, and whether a patient has major medical problems. Your doctor will discuss your likelihood of complications before you undergo the test.