Gastroenterology

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Introduction to Endoscopic Retrograde Cholangiopancreatography (ERCP)

The Endoscopic Retrograde Cholangiopancreatography (ERCP) procedure is used for treating and diagnosing conditions which cause blockage of bile and pancreatic ducts resulting in abdominal pain.

Written by Doctify Team 27/04/2020

What is an Endoscopic Retrograde Cholangiopancreatography (ERCP)?

The Endoscopic Retrograde Cholangiopancreatography (ERCP) procedure is used for treating and diagnosing conditions which cause blockage of bile and pancreatic ducts (tube like structures from which digestive juices and bile is secreted) resulting in abdominal pain. Narrowing of these ducts can be due to tumors, stones, inflammation of pancreas, scarring of ducts (sclerosis) etc. In ERCP, an endoscope (thin flexible tube with a camera) is inserted from the mouth till it reaches the duodenum (part of the small intestine) and X-rays are taken to view ducts and the narrowed or blocked areas.

How is an Endoscopic Retrograde Cholangiopancreatography (ERCP) performed?

ERCP is conducted by trained doctor at a hospital or outpatient centre. Using an IV (intravenous) line medicines are given to relax and sedate the patient. Sometimes, patients receive a local anesthetic as spray to numb the throat. Dentures are to be removed and a mouth guard is placed in the mouth to protect the teeth.
The endoscope is inserted through the mouth which goes through the food pipe (esophagus) and stomach until it reaches the duodenum. A thin tube is passed through the endoscope and inserted into pancreatic and gall bladder ducts. A special dye known as contrast medium is injected into these ducts, and x-rays are taken to see blocked areas.
Additionally, using tools guided through the endoscope, blocked ducts are opened by breaking and crushing stones, removing tumors in the ducts, or stretching out narrowed segments. Finally, tissue samples are taken that are later examined with a microscope for signs of infection or cancer.

How to prepare for an ERCP?

No food or drink is to be taken at least 4 hours before the test.
The doctor needs to be informed before the procedure if you have any allergies to iodine dye or other contrast agents used to take x-rays
No jewelry is to be worn so that it will not interfere with the x-rays.
Before the appointment, patients should make plans for a ride home as driving is not permitted 12-24 hours after the procedure (to allow time for sedatives effect to wear off).

What happens after an ERCP?

ERCP can cause some bloating or gas for about 24 hours. Some patients experience a sore throat for the first few days after procedure.
Only light activity can be done on the first day, and heavy lifting is to be avoided for the next two days. Pain can be treated using Tylenol (aspirin, ibuprofen, or naproxen are to be AVOIDED).

Risks from the procedure include: Reaction to the sedatives or contrast dye used during the procedure, bleeding, Pancreatitis (inflammation of pancreas), and perforation (puncture) of the GI tract or ducts.

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