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What is ERCP?

ERCP or Endoscopic Retrograde Cholangiopancreatography involves the use of an endoscope to view your bile and pancreatic ducts. ERCP is used to help locate and treat blockages in these ducts. The procedure helps find the source of your pain and plan surgery, if needed. It may also be used to locate problems in the pancreas. During ERCP, obstructing gallstones can be removed and a stent can be placed across narrowed segments. Also, during ERCP, strictures can be dilated, specimen can be collected for examination and sphincter pressure can be measured and sphincter dysfunction treated.

The Bile Ducts and Pancreatic Duct

These ducts carry bile from the liver/gallbladder and enzymes from the pancreas to the duodenum, the beginning of the small intestine. Gallstones, tumors, strictures, and sphincter dysfunction can cause blockage of these ducts. Pain and infection may occur and jaundice may develop.

Preparing for ERCP

  • Talk to your doctor about any health problems you have or medications you take. Discuss any allergies, especially to contrast material (the special dye used for some x-rays)
  • Ask your doctor about the risks of ERCP. These include pancreatitis, irritation or infection, bleeding, bowel perforation, and reactions to medications used during ERCP.

  • You may be asked to take antibiotics ahead of time.
  • Try to avoid blood-thinning medications such as aspirin or Plavix for 1 week before ERCP.
  • Be sure your stomach is empty. Do not eat or drink for 8-12 hours before ERCP.
  • Have someone ready to drive you home or clothing and toiletries in case you stay.
  • X-rays will be taken during exam, inform the doctor if you are pregnant.

The Procedure

ERCP usually takes 30 minutes. An IV is started to give you medications that make you sleepy.

Placing the Endoscope

To ease any discomfort you may feel, your throat will be numbed prior to the procedure. The endoscope (a flexible and narrow viewing tube) is then placed into your throat. The scope lets the doctor see all the way through the esophagus, stomach and the duodenum to the opening of the common bile duct. During this part you may have a gagging feeling. You may also feel pressure on your stomach.

Taking X-rays

During the procedure x-rays are taken. Contrast dye is injected through a catheter to make the duct show up on the x-ray.

After ERCP

Your doctor will discuss the test results with you. A return visit may be scheduled. You may go home the same day or spend the night in the hospital.

Excerpt from Endoscopic Retrograde Cholangiopancreatography (ERCP), a St. Luke's Medical Center advertorial.