Endoscopic retrograde cholangiopancreatography (ERCP) is a technique used to diagnose and treat disorders of the pancreatic and biliary ductal systems, as well as the liver, gallbladder, and pancreas. It combines endoscopy with fluoroscopy (live X-ray).
Indications for ERCP
Some of the indications for ERCP include:
- Treating blockage in the bile or pancreatic ducts due to gallstones, strictures, cancer, or compression from nearby tissues
- Jaundice (yellowing of the skin due to blockage of the bile duct)
- Persistent or recurrent upper abdominal pain that cannot be diagnosed by other tests such as MRCP/MRI or CT
- Confirming a diagnosis of pancreatic or bile duct cancer and planning treatment
How to prepare
- Inform your doctor of any medications, vitamins, or supplements you are taking.
- Inform your doctor of any allergy to medication, anesthetic, or contrast agent.
- Avoid eating and drinking for 8 hours before the procedure.
- Arrange for someone to drive you home after the procedure.
What to expect during the procedure
- You will lie on an examination table for the procedure.
- The procedure may be performed under sedation and local anesthesia or under general anesthesia. An intravenous (IV) needle will be placed in your arm.
- After a local anesthetic is applied to the throat, the doctor inserts an endoscope through your mouth, esophagus, and stomach to reach the duodenum, where the bile and pancreatic ducts open.
- A small camera on the endoscope captures magnified images on a monitor.
- The doctor locates the opening where the bile and pancreatic ducts empty into the duodenum.
- A catheter is inserted through the endoscope into the ducts, and a contrast dye is injected to make the ducts more visible on X-ray.
- Fluoroscopy (live X-ray) identifies areas of blockage or other abnormalities.
- Tiny tools may be passed through the endoscope to open blocked or narrowed ducts and to remove or break up gallstones.
- Temporary stents may be placed to keep ducts open or to prevent bile leaks after gallbladder surgery.
- The procedure often takes between 1 and 2 hours.
After the procedure
You will be transferred to the recovery area until the anesthesia wears off. You may experience a sore throat and minor cramps. You can usually resume eating the day after the procedure.
Risks and complications
Some of the risks and complications of ERCP include:
- Infection
- Inflammation of the pancreas or gallbladder
- Excessive bleeding
- Duct perforation, or damage to the small intestine, esophagus, or stomach